Vaginal vault dehiscence with evisceration after total laparoscopic hysterectomy
© Springer-Verlag 2010
Received: 2 April 2010
Accepted: 9 June 2010
Published: 3 July 2010
Vault dehiscence and evisceration of peritoneal contents is a rare complication following total hysterectomy. A 43-year-old lady presented with history of something soft coming out per vaginum. She underwent total laparoscopic hysterectomy 2 months back for 16-week fibroid uterus.
On examination under anaesthesia, there was complete dehiscence of the vaginal vault with loops of small bowel protruding through the defect. To maintain the pneumo-peritoneum vagina was blocked using a simple vaginal tampon soaked in betadine solution (Fig. 2) .
On Laparoscopic evaluation the entire vault was deficient. There were no bowel, bladder or omental adhesions to the vault. The prolapsed ileal loops were seen just at the vault, with healthy pink colour and regular peristalsis. On giving Trendelenburg’s position the reposition was smooth. After confirming that the vault was free of any adhesions, the vault was closed vaginally using interrupted no 1 Polydioxone II sutures (Fig. 3). Patient was discharged on the third post-operative day and is asymptomatic at 6-month follow-up.
- Rakesh Sinha, Meenakshi Sundaram, Smita Lakhotia et al (2009) Total Laparoscopic hysterectomy for large uteri. J Gynec Endosc Surg 1(1):34–39View ArticleGoogle Scholar
- Somkuti SG, Vieta PA, Daugherty JF, Hartley LW, Blackmon EB (1994) Transvaginal evisceration after hysterectomy in premenopausal women: a presentation of three cases. Am J of Obstet Gynecol 171:567–568Google Scholar
- Agdi M, Al-Ghafri W, Antolin R, Arrington J, O’Kelley K, Thomson AJ, Tulandi T (2009) Vaginal Vault dehiscence after hysterectomy, J Minim Invasive Gynecol. Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada, pp 313–317Google Scholar