Re: Vaginal Cuff Evisceration
From: R. Daniel Braun (rd.braun@gmail.com)
Tue Jun 28 09:15:12 2005
Many years ago, we had a similar one. Except when we asked her who she had
been having sex with, she replied "LeRoy!" We never did find LeRoy though.
On 6/28/05, Atkinson, Samuel M <ATKINSONS@mail.ecu.edu> wrote:
>
> Many years ago on a Saturday afternoon a 16 yo came to the ED with the
> CC of vaginal bleeding. Esam revealed a perfectly clean, almost
> surgical, posterior colpotomy. I repaired it vaginally. In spite of
> negative x-rays (I didn't have MRI in the dark ages) I did explore her
> for a foreign body.
> She insisted she woke up bleeding and refused to tell me any more. As
> her family had no insurance, she came by weekly for mos to pay on the
> account. I offered to zero the account if she would tell me how it
> occurred. She only replied that "You are too young (and possibly the
> wrong race) to understand." I subsequently delivered her twice, tied
> her tubes and she never revealed the answer to my questions. The
> condition never recurred!
>
> -----Original Message-----
> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Andrew
> Folley
> Sent: Monday, June 27, 2005 9:11 AM
> To: Multiple recipients of list OB-GYN-L
> Subject: Re: Vaginal Cuff Evisceration
>
> 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
> >
>
--
R. Daniel Braun
Kinky for Governor
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