BMJ Case Reports 2011; doi:10.1136/bcr.10.2010.3410
  • Unusual presentation of more common disease/injury

Spontaneous vaginal evisceration

  1. O'Mahony F1
  1. 1Department of Obstetrics and Gynaecology, University Hospital of North Staffordshire, Stoke-on-Trent, UK
  2. 2Surgical Directorate, Princess Royal Hospital, Apley Castle, Telford, UK
  3. 3Surgery Department, University Hospital of North Staffordshire, Stoke-on-Trent, UK
  1. Correspondence to Samee A, abdussamee2003{at}


Management of vaginal prolapse in the elderly lacks a uniform consensus and continues to remain challenging. The authors report a case of an elderly lady who presented with a spontaneous vaginal evisceration. She had a long-standing vaginal prolapse being controlled by a shelf pessary, which, in her case became displaced 2 weeks prior to admission. The patient underwent a laparotomy with an intent to replace the bowel back within the peritoneal cavity and repair the vault. During the pelvic floor repair, she sustained an inadvertent button-hole injury to the rectum, which was oversewn. She went on to develop a rectovaginal fistula requiring a de-functioning colostomy. The patient made good recovery subsequently.


  • Competing interests None.

  • Patient consent Obtained.

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