Two Cases of Prolapse of the Small Intestine Through a Ruptured Vagina after Hysterectomy

Abstract

We report two cases of prolapse of the small intestine through a ruptured vagina after hysterectomy. Case 1, a 33-year-old woman, underwent laparoscopic hysterectomy for ovarian cancer. Two months later, she visited our hospital with lower abdominal pain after sexual intercourse. Since the small intestine was eviscerated from the vagina, we performed emergency laparotomy. The small intestine was reduced into the peritoneal cavity, and the dehiscent vaginal cuff was repaired. We also found mesenterium commune. Case 2, a 53-year-old woman, underwent abdominal hysterectomy for uterine fibroids. Two months later, she visited our hospital with lower abdominal pain after evacuation. Since the small intestine was eviscerated from the vagina, we performed emergency laparotomy. The small intestine was reduced into the peritoneal cavity, and the dehiscent vaginal cuff was repaired. We found mesenterium commune in this case as well. Prolapse of the small intestine through a ruptured vagina after hysterectomy is a rare complication. However, it could cause intestinal obstruction and ischemic necrosis. Therefore, the possibility of this complication should be carefully considered in patients presenting with lower abdominal pain after hysterectomy.