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#1
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03-02-2011, 08:10 AM
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 ✖ The Antique Christ ✖ Poster Rank:105 Gonzo Punk Join Date: Jan 2009 Posts: 15,488
Contributions: 58
Mentioned: 23 Post(s) Quoted: 2046 Post(s)
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Traumatic Vaginal Evisceration Following A Motor Vehicle Crash
Pessary-Induced Traumatic Vaginal Evisceration Following A Motor Vehicle Crash Vaginal evisceration after a motor vehicle crash caused by a pessary has not been reported. This case was missed at the first emergency department visit, highlighting the importance of taking a careful gynecologic history in patients with trauma. Work was done at Memorial Hospital, South Bend, IN. Visceral vaginal evisceration following a motor vehicle accident is a rare event. We report a case of herniation and prolapse of intra-abdominal contents through a traumatic rupture of the vaginal vault into the introitus following a motor vehicle accident. The patient was a 56-year-old postmenopausal female who had years in the past undergone a vaginal hysterectomy. Post operatively she developed a vaginal vault prolapse and was using a #7 ring pessary to support the vaginal vault until definitive repair could be done. On the day of admission to the emergency department she was the restrained driver in an automobile accident in which her automobile was struck on the right front side. There was no intrusion into the driver's space but significant damage to her automobile. The patient complained of generalized aches and pains including some minor suprapubic pain. She was subsequently evaluated and released. Over the next 48 hours she had increasing abdominal and suprapubic pain. The pain became so severe that an ambulance and paramedics were called to her home. Prior to the arrival of emergency personnel she removed the pessary and the vaginal vault prolapsed through the introitus, containing herniated viscera. The exam in the emergency department was unremarkable except for the protrusion of epiploic fat of the small bowel through an approximately 4 cm long laceration of the vaginal vault (Figure 1, left). A CT Scan of the abdomen revealed a small amount of free air in the pelvis. There was no incarceration of the small bowel and the decision was made to repair the defect in the vaginal vault through a vaginal approach (Figure 2). The patient was taken to surgery. A pack was placed in the vagina and the vault prolapse was reduced. The patient was placed on prophylactic antibiotics and her recovery was uneventful. Elective abdominal vaginal vault suspension at a later date was scheduled.  ·  · |
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#7
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03-02-2011, 03:11 PM
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 My Rank: STAFF SERGEANT Poster Rank:777 Join Date: Oct 2010 Posts: 1,015 Mentioned: 2 Post(s) Quoted: 34 Post(s)
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Re: Traumatic Vaginal Evisceration Following A Motor Vehicle Crash
sometimes it is necessary for a woman to wear a pessary it keeps what belongs in in which no doubt is better than it hanging out it also is a multi purpose thing it can be used as a teething ring so now you can chew something other than the fat when you're hanging out. imagine that!  · |
