Enterocele: a review.

An enterocele is a hernia of the small intestine into the vagina. First described in 1736, it is an uncommon but potentially quite symptomatic clinical entity. Despite increased interest in enterocele during the past 50 years, there are few large series reported, and follow-up on surgical results has generally been poor. Many enteroceles follow vaginal or abdominal hysterectomy. Various surgical techniques for repair of enterocele are presented herein, including the classical repairs by Ward and Moschcowitz. Because enterocele frequently coexists with vaginal vault prolapse, contemporary procedures for simultaneous repair are described. Emphasis is placed upon prophylactic vaginal vault suspension and cul-de-sac obliteration at the time of abdominal or vaginal hysterectomy. The complications of failure to recognize enterocele are spontaneous vaginal evisceration, although rare, and progressive symptomatology. Attempted repair may also engender complications, some life-threatening.