Repair of a vaginal evisceration following colpocleisis utilizing an allogenic dermal graft.

Vaginal evisceration following colpocleisis is a very rare event and, to our knowledge, there has only been one previous case report. An 86-year-old woman presented to the Emergency Department with acute onset of abdominal pain occurring following a bowel movement. Six months previously, she had undergone a colpocleisis for recurrent vaginal vault prolapse. On presentation to the emergency room, she was noted to have 60 cm of necrotic small bowel protruding through her vaginal introitus. She was taken to the operating room for resection of the small bowel and closure of her colpocleisis. The closure of the vaginal defect was difficult and required a vaginal approach employing an allogenic dermal graft. This was accomplished and the patient had an uneventful recovery and was discharged home. At 18 months followup, she has had no complication or recurrence. Evisceration following colpocleisis is a rare event, but can be very difficult to manage and we suggest consideration of employing a graft to reinforce the repair.