Transvaginal small bowel evisceration after rectal cancer resection.
Boluwatife Oladapo Ayantunde, Sanskriti Srivastava, Kevin Seebah et al.
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Case in brief
A woman in her 70s with a history of rectal cancer resection presented with acute abdominal and pelvic pain after persistent coughing, leading to a perineal mass. Examination revealed eviscerated small bowel loops through a posterior vaginal wall defect. Emergency laparotomy allowed for transabdominal and vaginal reduction of the bowel and repair of the defect, avoiding bowel resection. The patient was discharged on postoperative day 5 with a well-healed vault.
Diagnostic / clinical pearl
Clinicians should consider transvaginal evisceration in postmenopausal women with a history of pelvic surgery and radiotherapy, especially when presenting with abdominal and pelvic pain.
Why it matters
This case underscores the potential role of vaginal estrogen in managing complications following surgical repair of vaginal wall defects.