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Re: Vaginal Cuff EviscerationFrom: Andrew Folley (agfolley@hotmail.com)Mon Jun 27 08:10:00 2005
Over the weekend I had a 23 yo woman come in to ER with pelvic and abdomianl pain acute onset with cramping and vaginal bleeding. She had had a hsyterectomy by my partner in December 2004. (Severe endomietriosis pelvic pain etc) I examined her and she had a 2 by 3 cm. opening in her vaginal cuff at the site of closure. What is particularly bizarre is that she had a similar presentation in April about 8 weeks previously. She had signs of acute abdomen then and was explored by surgery with large midline abdominal incision and found to have a "abdominal /vaginal " perforation or opening in cuff. It was repaired abdominally by her original GYN at that time. I could put 2 fingers into the cuff opening and visualize small bowel through tht vagina although it had not prolapsed through the cuff. WBC and Hb normal. he denies any unusual sexual practices. No durgs smoking, no steroids, no diabetes, weighs 130 pounds. What would you do now?? andrew >
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