Vaginal prolapse of the small intestine. A rare clinical presentation

A spontaneous transvaginal evisceration is a rare clinical event. The case of a 61-year-old woman is described. It is often associated with previous vaginal surgery as well as postmenopausal hypoestrogenism and therefore atrophy of the vaginal vault. The primary treatment is characterized by laparotomy and reposition of the prolapsed bowel. After assessing the viability resection of compromised segments is indicated. However, the main surgical problem is the prophylaxis of recurrence. Beside the repair of the vaginal disruption a colpocleisis, colpectomy, sacropexia or obliteration of the Douglas cavity is necessary.