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Re: Vaginal Cuff EviscerationFrom: Atkinson, Samuel M (ATKINSONS@mail.ecu.edu)Tue Jun 28 08:03:54 2005
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
> FREE!
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