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Revista Colombiana de Cirugía
Print version ISSN 2011-7582On-line version ISSN 2619-6107
Abstract
PAZMINO-MEDINA, Jorge; ZURITA-AGUIRRE, Gabriela; COELLO-VERGARA, Jonathan and MARIN-CASTRO, Pedro. Evisceration of the small intestine through the posterior perineum as presentation of interrecto-vaginal hernia: a case report. rev. colomb. cir. [online]. 2021, vol.36, n.4, pp.732-737. Epub Feb 18, 2022. ISSN 2011-7582. https://doi.org/10.30944/20117582.827.
Introduction.
The enterocele is produced by an hernia defect of the pelvic floor, being the most common the interrecto-vaginal hernia. It is produced by weakness of the pelvic floor for multiples factors, among them surgeries of the pelvic region, chronic constipation or pathologies that increase intra-abdominal pressure, a history of rectal or vaginal prolapse, and congenital factors.
Case report.
A 84-year-old female patient, with a history of eutocic delivery and multiple surgical procedures, including hysterectomy 40 years ago and rectosigmoidectomy for complicated diverticular disease 6 years ago, presented four months earlier with chronic constipation, which worsens in the days before her admission, with intense perineal pain and exit of intestinal loops at the level of the perineal region, which forced her to consult the emergency room. At examination the intestinal loops were found exposed, with color changes, she underwent surgery with satisfactory results, optimal immediate postoperative and outpatient follow-up for 3 months with no evidence of recurrence.
Discussion.
Interrecto-vaginal hernia has a low incidence and a varied clinical presentation. The only treatment is surgery.
Keywords : pelvic floor; perineum; Douglas’ pouch; hernia; small intestine; enterocele.