A 55-year-old post-menopausal woman from Panvel has been successfully treated for a rare and life-threatening condition known as transvaginal evisceration of the bowel, following an emergency surgical intervention at Medicover Hospital, Navi Mumbai.
The patient, identified as Hema Shukla (name changed), had been experiencing severe abdominal pain, visible small bowel prolapse through the vaginal vault, and difficulty passing motion for over two years. However, she had ignored the symptoms until the condition worsened, prompting an emergency referral to Medicover Hospital.
Dr. Kalpana Gupta, Obstetrician and Gynaecologist at Medicover Hospital, explained that the patient suffered from a condition called delayed vaginal vault dehiscence with small bowel prolapse and obstruction, which is extremely rare, affecting fewer than 0.1% of women and typically occurring in post-menopausal women with a history of pelvic surgeries, such as hysterectomy. The condition arises due to inadequate pelvic support after such surgeries, compounded by poor nutrition and hygiene.
Given the severity of the situation, Dr. Gupta and her team immediately performed a two-stage surgical procedure to save the patient’s life. The first stage involved an exploratory laparotomy, performed by experienced general surgeon Dr. Sangram, to address the bowel obstruction and prevent further damage to the intestines. The second stage, carried out three months later, was a laparoscopic procedure known as sacrocolpopexy, which reinforced the vaginal vault by attaching it to the sacrum with surgical mesh. This procedure also included anterior and posterior colpopexy to prevent future prolapse and ensure the integrity of the tissues.
Dr. Gupta highlighted the importance of early diagnosis and timely intervention, as well as advanced imaging techniques to accurately identify such rare conditions. “This case demonstrates how a staged surgical approach can provide the best outcomes for patients with complex conditions like transvaginal evisceration,” she said.
