Small bowel evisceration after vaginal cuff rupture is a seldom seen surgical emergency. We report on a case of rupture seen in the emergency department in a patient eight weeks post hysterectomy. She presented to the emergency department by ambulance in the early morning hours with the complaint of acute severe abdominal pain along with nausea and vomiting. Diagnosis of this condition was confirmed after a thorough physical exam. Following manual reduction in the emergency department and immediate transfer for surgical repair helped the patient avoid the morbidity and mortality associated with this complication. This allowed her to be discharged home later the same day.

Purpura fulminans is a seldom seen manifestation of sepsis in the emergency department (ED). The morbidity and mortality of sepsis have been widely studied and reported; the hallmark of treatment is early recognition and intervention. In extreme cases, sepsis can cause widespread activation of the coagulation cascade further complicating the treatment and recovery from the causative pathogen. We report two cases and their differing outcomes after presentation to the ED with similar dermatologic findings on initial physical exam.