Delayed presentation of vaginal cuff dehiscence and evisceration loop of bowel nine month after laparoscopic hysterectomy: A case report

INTRODUCTION AND IMPORTANCE: Vaginal cuff dehiscence (VCD) is an extremely rare condition and requires emergency surgery due to the possibility of developing acute small bowel ischemia, peritonitis, and sepsis. Etiology is unclear but multifactorial. CASE PRESENTATION: A 57-year-old nullipara postmenopausal female patient with small bowel evisceration due to vaginal cuff dehiscence while having sexual intercourse six hours earlier on arrival to the hospital. She had a history of laparoscopic hysterectomy 9 months before. For that reason, we performed an emergency laparotomy which we reduced the intestine and we closed vaginal cuff. CLINICAL DISCUSSION: Dehiscence of the vaginal cuff and evisceration involve rupture of the proximal vaginal cuff, resulting in the expulsion of intraperitoneal contents. This is unusual case can be identified clinically, and the management is surgical which can be performed transvaginal and transabdominal approach to repair the vaginal cuff. However, before repairing the vaginal defect, the bowel should be checked if there is any doubt about the need for bowel resection and anastomosis. CONCLUSION: Transvaginal evisceration is a very rare disease that can be life-threatening. It needs to be identified quickly and treated surgically to prevent small bowel ischemia.