Spontaneous transvaginal small bowel evisceration: a case report

Spontaneous evisceration through the vagina was first described in 1907 by McGregor. To date, only eighty-five cases of transvaginal small bowel evisceration have been documented worldwide. The primary risk groups for spontaneous vaginal evisceration include postmenopausal women, vaginal surgery cases, multiparae, and women of older age. In postmenopausal woman, transvaginal evisceration is frequently associated with increased abdominal pressure, vaginal ulceration due to severe atrophy, and straining at stool. Vaginal evisceration is a medical emergency that requires prompt recognition and immediate surgical intervention. The associated mortality rate is 5.6 percent; however, the incidence of morbidity is higher when the bowel has become strangulated through the vaginal defect. Here, we report a case of vaginal vault rupture with evisceration through the vagina and highlight the risk factors, clinical presentation, and treatment options for this rare gynecological emergency.