Vaginal evisceration due to late dehiscence of the vaginal vault

Abstract

Vaginal evisceration due to dehiscence of the vault is a fearsome and rare complication that can appear after the total abdominal hysterectomy, the time that can occur is variable from days to 30 years after the surgery. The diagnosis is clinical and the surgical treatment associated with the use of broad-spectrum antibiotic therapy should be immediate as it is an emergency with a risk of mortality close to 10% by secondary peritonitis and septic shock. We present the case of a 72-year-old female white patient with a history of total abdominal hysterectomy due to uterine fibroma about 10 years ago, who went to the surgical guard for presenting thin loops out of the vaginal. Emergency exploratory laparotomy was performed finding continuity loss of approximately 7 centimeters in vaginal vault, confirming the diagnosis, where prolapse about 40 centimeters of terminal ileum, managing to reduce it without accident. Exploration of the reincorporated portion showed no perforation or vascular involvement. The vaginal vault is closed through the abdomen and then given a vaginal background. She presented no postoperative complications, discharged from hospital on the eleventh day.