# Recurrent vaginal evisceration of abdominal contents with subsequent resection of necrotic omentum in a 35-year-old woman

## TL;DR

A 35-year-old woman experienced a rare recurrence of vaginal evisceration after prior surgeries, requiring surgical repair and highlighting the need for preventative measures.

## Contribution

This case report presents a rare instance of recurrent vaginal evisceration and emphasizes surgical and educational strategies to prevent recurrence.

## Key findings

- Recurrent vaginal evisceration occurred five months after initial repair in a patient with prior gynecologic surgeries.
- Surgical teams successfully reduced abdominal contents and resected necrotic omentum via a transabdominal approach.
- Use of a dehydrated placental allograft was part of the surgical repair to reinforce the vaginal cuff.

## Abstract

Vaginal evisceration is a rare surgical emergency in which intra-abdominal contents protrude through a dehisced vaginal cuff, which can lead to bowel ischemia and abdominal sepsis. This condition occurs due to vaginal cuff weakness secondary to prior surgeries or trauma. Recurrence after repair is rare and few cases have been documented. Here we present a young woman with multiple prior gynecologic surgeries who presented with eviscerated small bowel and omentum from her vagina five months following surgical treatment of a previous vaginal evisceration. Via a transabdominal surgical approach, general surgery and gynecology teams reduced the intra-abdominal contents, resected a pedicle of necrotic omentum, suture repaired the vaginal cuff, and placed a dehydrated placental allograft. This extremely rare case of recurrent vaginal evisceration demonstrates the importance of taking appropriate preventative surgical measures, maintaining a healthy level of suspicion for recurrence, knowing potential complications, and educating patients to prevent recurrent vaginal evisceration.