Spontaneous vaginal evisceration and intraabdominal small bowel strangulation: a report of the first case and review of the literature

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Vaginale Eviszeration ist eine seltene gynäkologische Komplikation mit akutem Handlungsbedarf.




Die prädisponierenden Faktoren für diese Erkrankung, das klinische Bild und das Management werden dargestellt. Eine von uns durchgeführte Medline-Suche hat keinen Fall einer solchen vaginalen Eviszeration erbracht.


Unser Fall zeigt, dass ein abdominell vaginaler Zugang bei der chirurgischen Therapie der vaginalen Eviszeration gewählt werden soll, wenn nicht klar ist, ob Darm und Mesenterium beteiligt sind.


Vaginal evisceration is an extremely rare gynecological event, which represents a surgical emergency.


We present an interesting and unusual case of strangulated intra-abdominal segment of small intestine associated with spontaneous evisceration of an incarcerated but viable loop of the distal ileum through vaginal vault six months following vaginal hysterectomy.


The predisposition factors, mode of presentation, pre-operative management and surgical approach are discussed. A MEDLINE search (English language; 1900, July 2005; search terms: “Vaginal”, “evisceration” and “Maydl's hernia”) revealed no other cases.


Our case suggests that a combined abdominal and vaginal approach should be performed when the viability of the bowel or mesenteric involvement cannot be adequately assessed. We recommend that postural or manual reduction via a vaginal approach should not be attempted as it may result in a gangrenous intraabdominal loop of bowel being missed; a lethal outcome if unrecognized.

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