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Unusual presentation of more common disease/injury
Spontaneous vaginal evisceration
  1. Siddiqui I1,
  2. Samee A2,
  3. Hall C3,
  4. Cooper J1,
  5. 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.

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  • Competing interests None.

  • Patient consent Obtained.

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