Vaginal cuff dehiscence with adnexal mass evisceration after abdominal hysterectomy

Nguyen, My-Linh Thi; Anyikam, Adanna; Paolucci, Michele

doi:10.1016/j.ijscr.2013.02.012

Cited by 4 publications

(3 citation statements)

References 8 publications

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“…El íleon terminal es la víscera implicada más frecuentemente, pero también se han publicado casos más raros de salida de epiplón, trompas de Falopio, apéndice y un único caso de quiste ovárico (6).…”

Section: Discussionunclassified

Evisceración vaginal tras tratamiento con radioterapia e histerectomía abdominal

S²,

et al. 2015

Rev. chil. obstet. ginecol.

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RESUMENLa evisceración vaginal es una complicación muy rara. Es más frecuente en mujeres posmenopáusicas y con antecedente de cirugía vaginal, fundamentalmente histerectomía. También puede darse en mujeres premenopáusicas, vinculándose en estos casos a traumatismos, iatrogenia o introducción de cuerpos extraños. El íleon distal es el órgano más frecuentemente eviscerado, aunque el prolapso de epiplón, trompas de Falopio y apéndice también se han descrito. Presentamos el caso de una mujer de 43 años con evisceración transvaginal de epiplón a los seis meses de realizarse una histerectomía abdominal por recidiva de un cáncer escamoso de cérvix. PALABRAS CLAVE: Evisceración vaginal, histerectomía, dehiscencia, cúpula vaginal SUMMARYVaginal evisceration is a very rare complication. It is more often in postmenopausal women with a history of vaginal surgery, mainly hysterectomy. It can also occur in premenopausal women, linking these cases to trauma, iatrogenic or foreign bodies. The distal ileum is most often gutted organ prolapse, although omentum, fallopian tubes and appendix are also described. We report a 43-year old transvaginal omental evisceration after six months of an abdominal hysterectomy for recurrent squamous cervical cancer. KEY WORDS: Vaginal evisceration, hysterectomy, dehiscence, vaginal cuff INTRODUCCIÓNSe define evisceración como la salida de vísce-ras abdominales, quedando expuestas, a través de un orificio no natural (1). Es una complicación poco frecuente. Su incidencia, oscila entre 0,03 y 4,1% (2). Partsinevelos y cols en 2009, publicaron una revisión de 51 casos donde el mayor porcentaje de casos se produjo tras histerectomía abdominal (47%), luego de histerectomía vaginal (29,4%) y por último después de abordaje laparoscópico (23,6%) (3). Un estudio en 2012 señalaba una incidencia mayor de dehiscencia de cúpula vaginal después de histerectomía laparoscópica (1,14%) que tras histerectomía abdominal (0,10%) y vaginal (0,14%) (4).Analizando los diferentes abordajes laparoscó-picos de la histerectomía, la incidencia de evisceración es mayor en la histerectomía total laparoscópica que en la histerectomía vaginal asistida por laparoscopia, y la sutura intracorpórea de la cúpula vaginal en la histerectomía laparoscópica obtiene mejores resultados que la sutura vía vaginal (5). 256REV CHIL OBSTET GINECOL 2015; 80(3): 256 -260

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Section: Discussionunclassified

Evisceración vaginal tras tratamiento con radioterapia e histerectomía abdominal

S²,

et al. 2015

Rev. chil. obstet. ginecol.

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“…Although it is more commonly seen in laparoscopic and robotic hysterectomy [ 6 ], it can be also seen in abdominal and vaginal route as in the current case. It is mostly seen in three months after hysterectomy, occurring earlier in endoscopic route [ 7 ]. Interestingly, it occurred on day 21 of operation in our case and risk factors are blamed for early development of VVD.…”

Section: Discussionmentioning

confidence: 99%

Vaginal repair of vaginal vault dehiscence after postpartum hysterectomy

Avcıoğlu¹,

Altınkaya²,

Küçük

et al. 2014

Journal of Surgical Case Reports

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Vaginal vault dehiscence (VVD) may occur rarely after hysterectomy. Although mostly, a vaginal cuff dehiscence is seen after robotic or laparoscopic hysterectomy, it may also be observed as a complication of abdominal or vaginal hysterectomy. Vaginal repair is one of the techniques used for VVD. Here, we will describe a case of vaginally repaired VVD, associated with intra-abdominal hematoma after postpartum hysterectomy.

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“…Dehiscence of the vaginal cuff after hysterectomy occurs predominantly after coitus in premenopausal women [ 4 ]. Transabdominal hysterectomies have the lowest incidence of vaginal cuff dehiscence than other methods of hysterectomies, such as laparoscopic, robotics, or vaginal [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Transvaginal Management of Vaginal Cuff Dehiscence with Bowel Evisceration following Delayed Diagnosis

Bleull

Smith

Shapiro

2017

Case Reports in Obstetrics and Gynecology

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One of the most serious complications that can arise from hysterectomy is vaginal cuff dehiscence with subsequent bowel evisceration. Treatment via vaginal approach has been utilized in early cases of vaginal cuff dehiscence where the need for bowel resection is less likely. Our case examines the treatment of vaginal cuff dehiscence through a vaginal approach approximately 36 hours after apparent vaginal dehiscence with subsequent bowel evisceration. In this case, we chose a vaginal approach even in the setting of possible bowel obstruction and a significant leukocytosis. We utilized CT scan findings to help guide our surgical approach. Although the subjective appearance of the bowel protruding through the vaginal cuff was reassuring, this played little role in guiding our decision with regard to surgical approach. Vaginal cuff dehiscence with evisceration can be managed successfully via a vaginal approach even with prolonged exposure of the bowel to vaginal flora. CT scan should be utilized to evaluate bowel integrity when considering a vaginal dehiscence repair. A high index of suspicion is warranted as these cases can present up to many years after hysterectomy.

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Vaginal cuff dehiscence with adnexal mass evisceration after abdominal hysterectomy

Abstract: Any large pelvic mass that may potentially exert pressure necrosis on the vaginal cuff, even remote from hysterectomy may result a vaginal cuff dehiscence. Emergent surgical intervention is warranted.

Cited by 4 publications

References 8 publications

Evisceración vaginal tras tratamiento con radioterapia e histerectomía abdominal

Evisceración vaginal tras tratamiento con radioterapia e histerectomía abdominal

Vaginal repair of vaginal vault dehiscence after postpartum hysterectomy

Transvaginal Management of Vaginal Cuff Dehiscence with Bowel Evisceration following Delayed Diagnosis

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