Kumar Sunesh, Singhal Seema, Kansal Yamini, Sharma Dayanand
Professor, Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India.
Assistant Professor, Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India.
J Clin Diagn Res. 2017 Sep;11(9):QD01-QD02. doi: 10.7860/JCDR/2017/28389.10508. Epub 2017 Sep 1.
Vaginal Cuff Dehiscence (VCD) is partial or total separation of anterior and posterior vaginal cuff layers. We report a case of recurrent vault cuff dehiscence in a patient of cervical carcinoma. A 60-year-old treated case of carcinoma cervix post surgery and radiotherapy was found to have vault dehiscence and intestinal prolapse second time during a routine speculum examination. She underwent an emergency laparotomy and closure of vault. Vaginal Cuff Dehiscence with Evisceration (VCDE) is a rare but potentially fatal complication following hysterectomy. Postoperative infection, poor technique, hematoma, coitus before healing, radiotherapy, corticosteroid therapy are the risk factors. Radiotherapy leads to progressive obliterative endarteritis and resultant tissue hypoxia. There is paucity of literature regarding the best management of VCD, but early corrective intervention is necessary. Patients and the treating physicians should be made aware of this possibility especially those receiving adjuvant radiation or cases of robotic or laparoscopic hysterectomies.
阴道断端裂开(VCD)是阴道前后断端层的部分或完全分离。我们报告一例宫颈癌患者复发性穹窿断端裂开的病例。一名60岁宫颈癌患者在接受手术和放疗后,在常规窥器检查时第二次发现穹窿裂开和肠脱垂。她接受了急诊剖腹手术并关闭穹窿。伴有脏器脱出的阴道断端裂开(VCDE)是子宫切除术后一种罕见但可能致命的并发症。术后感染、技术欠佳、血肿、愈合前性交、放疗、皮质类固醇治疗均为危险因素。放疗会导致进行性闭塞性动脉内膜炎并导致组织缺氧。关于VCD的最佳治疗方法,文献报道较少,但早期进行纠正性干预是必要的。应让患者和治疗医生了解这种可能性,尤其是那些接受辅助放疗的患者或接受机器人或腹腔镜子宫切除术的病例。