Leandro Sofia, Leandro Rita, Martins Ana, Silva Artur, Carvalho Manuel
General Surgery, Hospital do Espírito Santo de Évora, Évora, PRT.
General Practice, Areeiro Family Health Unit, Lisbon, PRT.
Cureus. 2024 Dec 5;16(12):e75134. doi: 10.7759/cureus.75134. eCollection 2024 Dec.
Transvaginal evisceration is a rare, potentially life-threatening condition involving herniation of intra-abdominal contents, typically the small bowel, through a defect in the vaginal wall. Most commonly observed in postmenopausal women with a history of pelvic surgery or trauma, it necessitates prompt surgical intervention. We report a unique case of transvaginal evisceration in a 67-year-old postmenopausal female with rectovaginal prolapse following minor trauma. The patient presented with sudden pelvic pain and a mass protruding through the vaginal canal after lifting a heavy object. Examination revealed a loop of small bowel through the vaginal opening. She was hemodynamically stable, and initial management included bowel reduction and intravenous fluid administration. Emergency exploratory laparotomy confirmed a full-thickness defect in the posterior vaginal wall with approximately 40 cm of viable small bowel eviscerated. The defect was repaired with absorbable sutures, and the patient recovered uneventfully, being discharged on postoperative day five. This case underscores the importance of considering transvaginal evisceration in postmenopausal women with rectovaginal prolapse, even after minor trauma, to enable timely intervention and prevent severe complications.
经阴道脏器脱出是一种罕见的、可能危及生命的疾病，涉及腹腔内容物（通常是小肠）通过阴道壁缺损突出。最常见于有盆腔手术或创伤史的绝经后女性，需要及时进行手术干预。我们报告了一例独特的经阴道脏器脱出病例，患者为一名67岁绝经后女性，在轻微创伤后出现直肠阴道脱垂。患者在搬重物后突然出现盆腔疼痛，并有一个肿物经阴道管突出。检查发现一小段小肠经阴道口脱出。她血流动力学稳定，初始处理包括肠管还纳和静脉补液。急诊剖腹探查证实阴道后壁有一个全层缺损，约40厘米的存活小肠脱出。用可吸收缝线修复缺损，患者恢复顺利，术后第5天出院。该病例强调了对于有直肠阴道脱垂的绝经后女性，即使是轻微创伤后，也应考虑经阴道脏器脱出的可能性，以便及时干预并预防严重并发症。
