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Transvaginal evisceration of the intra-abdominal organs is a rare emergency event. In this paper, we discuss the case of a 97-year-old female who presented to the emergency department due to abdominal pain and a large prolapse with visible extrusion of the small bowel per vagina. Past surgical history was significant for a total abdominal hysterectomy and surgical repair for pelvic organ prolapse; both performed more than 15 years prior to the patient's current presentation. The eviscerated bowel was initially reduced through a vaginal vault defect into the abdominal cavity. A lower midline laparotomy was undertaken for further assessment, and the vault defect was closed by transabdominal repair with no evident compromise to bowel function. We suggest that a multidisciplinary approach to prompt examination and management by gynaecology and general surgery is vital in reducing the risk of morbidity and mortality.

Transvaginal Evisceration of the Small Bowel More Than 15 Years After Abdominal Hysterectomy and Vaginal Surgery