Vaginal cuff dehiscence – A potential surgical emergency

Vaginal cuff dehiscence is a rare, but potentially morbid, complication of a total hysterectomy. Bowel evisceration can lead to serious sequelae and is considered a surgical emergency however there is a paucity of information on it in the Emergency Medicine literature. We present the case of a 40 year old female with a chief complaint of vaginal bleeding and severe abdominal pain after sexual intercourse. She was s/p total laparoscopic hysterectomy 3 months earlier. The history and physical exam were concerning for vaginal cuff dehiscence (VCD). The patient underwent an Exam Under Anesthesia (EUA) and subsequent laparoscopic repair of the vaginal cuff defect and fully recovered.