Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan Province, P.R. China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, Sichuan Province, P.R. China.
BMC Womens Health. 2023 Sep 19;23(1):499. doi: 10.1186/s12905-023-02650-3.
Transvaginal small bowel evisceration is a life-threatening condition, which is usually seen in postmenopausal women with a history of gynecological surgery. Cervical loop electrosurgical excision procedure (LEEP) is widely used in the treatment of cervical intraepithelial neoplasia (CIN), and its surgical risk and postoperative complications are relatively low because of the simplicity of the operation. However, improper operation may result in perforation of the uterus, which can cause prolapse of the small bowel into the vagina. We here reported an extremely rare case of a young woman with transvaginal small bowel evisceration after cervical LEEP, achieving a good prognosis after the prolapsed bowel was reduced. The patient underwent cervical LEEP as a treatment for CIN III, but the LEEP resulted in a laceration of about 4.0 cm × 3.5 cm on the peritoneum of the uterovesical peritoneal reflection and a laceration of about 2.0 cm × 1.5 cm on the anterior wall of the cervical canal. Through the two lacerations, the pelvic cavity is connected to the vagina and the small intestine prolapsed into the vagina. Due to aggressive surgical intervention, the patient achieved a favorable prognosis after successfully reducing the prolapsed bowel.
经阴道小肠脱出是一种危及生命的疾病,通常发生在有妇科手术史的绝经后妇女中。宫颈环形电切术(LEEP)广泛用于治疗宫颈上皮内瘤变(CIN),由于手术简单,其手术风险和术后并发症相对较低。然而,不当的操作可能导致子宫穿孔,从而导致小肠脱垂进入阴道。我们在此报告一例年轻女性宫颈 LEEP 术后经阴道小肠脱出的极罕见病例,脱出的肠管复位后预后良好。该患者因 CIN III 而行宫颈 LEEP 治疗,但 LEEP 导致子宫膀胱腹膜反折的腹膜上有约 4.0 cm×3.5 cm 的裂伤,宫颈管前壁有约 2.0 cm×1.5 cm 的裂伤。通过这两个裂伤,盆腔与阴道相通,小肠脱垂入阴道。由于积极的手术干预,患者成功复位脱出的肠管后预后良好。