A Case of Transvaginal Small Bowel Evisceration following Hysterectomy with Discussion of Emergency Department Diagnosis and Management

Autor: Matthew Apicella, Maximiliano Mayrink, Chetan D. Rajadhyaksha, David A. Farcy
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Case Reports in Emergency Medicine, Vol 2022 (2022)
Druh dokumentu: article
ISSN: 2090-6498
DOI: 10.1155/2022/1334302
Popis: Transvaginal small bowel evisceration is a rare surgical emergency that requires urgent surgery to prevent bowel necrosis, sepsis, and death. It was first reported in 1864 by Hyernaux with less than 100 cases reported since the original publication. The overall mortality rate is reported as 5.6 percent. We present the case of a 49-year-old woman who presented to the emergency department with a chief complaint of moderate abdominal pain and vaginal bleeding for 1 hour. The patient reported that she underwent a robotic-assisted laparoscopic hysterectomy 11 weeks prior for uterine fibroids. Visual examination revealed a loop of the small bowel coming from the superior aspect of her vagina. Literature reviews have noted a higher incidence of dehiscence following robotic-assisted total laparoscopic hysterectomy. It is important for the emergency physician to make the diagnosis, initiate prompt consultation with departments of obstetrics and gynecology and general surgery, and treat for potential infection.
Databáze: Directory of Open Access Journals
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