Spontaneous transvaginal intestinal evisceration in an elderly woman

Abstract

Introduction: Transvaginal intestinal evisceration is a rare surgical emergency that is associated with morbidity and mortality. Only a few  cases of transvaginal evisceration have so far been described. The predisposing risk factors associated with this clinical condition are  multifactorial.

Case presentation: We report a case of an 85-year-old female that presented with spontaneous small bowel  evisceration through the vagina. The loops of the small bowel appeared edematous and thickened but there was demonstrable visible peristalsis. She had no previous laparotomy or vaginal surgery. An emergency laparotomy was performed, and the small bowel was  reduced into the abdomen through the vaginal defect. Afterward, a total abdominal hysterectomy was performed with the closure of the  vaginal vault. The postoperative period was uneventful.

Conclusion: The spontaneous evisceration of bowel loops can be successfully managed when patients with such cases present early and promptly managed. Prompt diagnosis and surgical management are crucial to  prevent complications. If the eviscerated viscera are non-viable, resection and restoration of bowel continuity are imperative.  Management should be individualized and multidisciplinary.