Atraumatic Spontaneous Transvaginal Small Bowel Evisceration: A Rare Surgical Emergency

TL;DR

A rare case of non-traumatic small intestine evisceration through the vagina in a 65-year-old woman is reported, requiring urgent surgical repair.

Contribution

This case report highlights a rare surgical emergency and emphasizes the importance of timely diagnosis and treatment.

Findings

Non-traumatic transvaginal evisceration of the ileum occurred in a postmenopausal woman with prior gynecologic surgery.

The patient required exploratory laparotomy and repair of the vaginal ampulla.

Clinical assessment is crucial for diagnosis and individualized treatment planning.

Abstract

Abdominal pain ranks as the predominant cause for emergency department consultations. Although rare, transvaginal evisceration of the small intestine necessitates immediate surgical intervention due to its potential to induce intestinal ischemia and peritonitis. Key risk factors include postmenopausal status, a history of gynecologic surgery, and heightened abdominal pressure. Clinical presentation typically involves pain and protrusion of intestinal contents or even abdominal viscera. Diagnosis relies on thorough clinical assessment, and treatment strategies should be tailored to each patient. Here, we describe the case of a 65-year-old female patient with a non-traumatic evisceration of the ileum, who had undergone total abdominal hysterectomy following anterior colpocele a year ago, subsequently necessitating exploratory laparotomy and repair of the vaginal ampulla.

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