Sneeze-induced transvaginal small bowel evisceration and obstruction nine months after iatrogenic vaginal vault laceration: a case report

Submitted: December 17, 2023
Accepted: January 28, 2024
Published: February 6, 2024
Abstract Views: 296
PDF: 114
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Authors

  • Francesco Salvetti francesco.salvetti02@universitadipavia.it https://orcid.org/0000-0001-8472-5823 Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia; Department of General Surgery, ASST Pavia - Ospedale Civile di Vigevano, Italy.
  • Alessandro Bergna https://orcid.org/0000-0001-6101-3989 Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia; Department of General Surgery, Humanitas San Pio X, Milan, Italy.
  • Lorenzo Poletti Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia; Department of General Surgery, ASST Pavia - Ospedale Civile di Vigevano, Italy.
  • Giulio Misitano Department of Obstetrics and Gynecology, ASST Pavia - Ospedale Civile di Vigevano, Italy.
  • Giulia Del Re Department of Pediatric Surgery, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy.
  • Daniele Belotti Department of General Surgery, ASST Pavia - Ospedale Civile di Vigevano, Italy.
  • Fabrizio Signorelli Department of General Surgery, ASST Pavia - Ospedale Civile di Vigevano, Italy.
  • Paolo Previde Massara Department of General Surgery, ASST Pavia - Ospedale Civile di Vigevano, Italy.
  • Luca Del Re Department of General Surgery, ASST Pavia - Ospedale Civile di Vigevano, Italy.

Transvaginal evisceration (TE) is the extrusion of intra-abdominal viscera through the vagina. According to the literature, few cases have been reported, most of them involving elderly women who underwent previous pelvic surgery. Here we present the case of a 72-year-old woman who was admitted to our hospital due to the sensation of vaginal obstruction that appeared after a sneeze nine months after a repair of a vault laceration following prior complex pelvic surgery. A clinical diagnosis of small bowel transvaginal evisceration with obstruction was quickly made. In this case, adhesions, bowel obstruction, and the presence of a fibrotic scar on the vaginal vault were the main obstacles to the repair. However, a multidisciplinary evaluation and a combined laparoscopic-transvaginal minimally-invasive approach proved to be safe and effective in achieving good surgical outcomes in the treatment of this condition.

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Citations

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How to Cite

Salvetti, F., Bergna, A., Poletti, L., Misitano, G., Del Re, G., Belotti, D., Signorelli, F., Previde Massara, P., & Del Re, L. (2024). Sneeze-induced transvaginal small bowel evisceration and obstruction nine months after iatrogenic vaginal vault laceration: a case report. Case Reports in Emergency Surgery and Trauma, 2(1). https://doi.org/10.4081/crest.2024.26