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Re: Vaginal Cuff Evisceration From: Garry E. Siegel, M.D. (garrys@mindspring.com) Mon Jun 27 10:51:42 2005 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: doctorjoe@aol.com: "Re: Vaginal Cuff Evisceration" Previous message: Gerald P. Rodríguez: "Re: Vaginal Cuff Evisceration" Use PDS suture--when this first came out a long time ago, one of our older attendings said use that "Pretty Damn Strong" suture :). Garry Seriously, don't know if I would use PDS or not; a delayed absorbable may really be a good idea, but I would have to also consider Monocryl, or maybe just Vicryl. It might be a good idea to see what the surgeon used, and how he closed it, if the op note is available. At Mon, 27 Jun 2005, Gerald P. Rodríguez wrote: > >She is not falling on picket fences. Some sort of vaginal penetration >trauma is occurring and it may just "normal" intercourse. I would attempt >to repair it from below but I would want some reassurance that the pelvis is >not harboring a foreign body. Perhaps the larger question is what can you do >now so that this does not happen a third time. > >Gerald P. Rodríguez, M.D., FACOG >Santa Fe > >>>----- Original Message ----- >From: "Andrew Folley" <agfolley@hotmail.com> >To: "Multiple recipients of list OB-GYN-L" <ob-gyn-l@dns.obgyn.net> >Sent: Monday, June 27, 2005 7:10 AM >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 >>> -- Garry E. Siegel, M.D. Private Practice Roswell, GA Next message: doctorjoe@aol.com: "Re: Vaginal Cuff Evisceration" Previous message: Gerald P. Rodríguez: "Re: Vaginal Cuff Evisceration"

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