Case report:
A 72-year-old patient, who underwent a 10 years ago a total vaginal hysterectomy for a mild disease, was admitted for abdominal pain with a loop of bowel prolapsed from her vagina, after an uplifting effort (Figure1).
The physical examination showed an evisceration of small bowel with satisfying vitality due to dehiscence of the vaginal cuff. Multiple loops of the small bowel and abdominal mesentery were involved. A digital rectal exam confirmed that there was no involvement of the rectum. We did not complete any radiological examination. We decided to operate on the patient in an emergency context. The preoperative blood tests were normal.
Under general anesthesia and after administration of intravenous antibiotics, the patient was placed in Trendelenburg position, and the loop of bowel was integrated into the abdominal cavity with a manual reduction (Figure 2 and 3) through the vaginal defect and the defect was repaired with a non-absorbable running suture (Figure 4). Post-operative period was uncomplicated; the patient was discharged on the 8th post-operative day and was addressed to the genecology team to fix the vaginal cuff dehiscence.