A case report of vaginal injury with peritoneal perforation from a water-jet accident: the first report of treatment by laparoscopic operation

Objective To describe a unique case of vaginal injury with peritoneal perforation from a water-jet accident that was treated by laparoscopic assisted operation. Subject A woman was transferred to our unit with a vaginal laceration caused by impact of water flow to the perineum after falling off of the back seat of a Jet-ski. A part of the appendix epiploica was seen in the vagina. Interventions In this particular case, by using a laparoscope and washing and draining the pelvic cavity, it was confirmed by the surgeon that there was no intestinal injury despite part of the colon having entered the vagina. The perforated vaginal wound was sutured transvaginally while draining the abdominal cavity. Compared with what would have been the case with laparotomy, the patient's need for pain killers and her recovery time were greatly reduced. Conclusions Patients with vaginal lacerations are often encountered in the emergency room. In treatment it is necessary to stop the bleeding and prevent infection. In the case of vaginal perforation, it is also important to check for intestinal or pelvic injury. Usually, open surgery is performed for these reasons. However, the authors managed to treat the woman using a laparoscopically assisted approach, and therefore the treatment was minimally invasive.