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As allergy season intensifies, doctors are issuing warnings about the potential dangers of severe coughing fits. These warnings come after a pair of unusual medical incidents, including a recent case involving a rare instance of bowel evisceration linked to intense coughing. Understanding these risks can help individuals take preventive measures during peak allergy periods.
The Rare Phenomenon of Bowel Evisceration
Earlier this year, physicians documented a case report detailing a 61-year-old woman from Taiwan who experienced a rare bowel evisceration. This condition involves parts of the intestines protruding outside the body.
While uncommon, similar occurrences have been recorded. One such case involved an 86-year-old woman from the UK in 2011 who, while battling a respiratory infection, suffered a similar evisceration of her small bowel through her vagina following a violent coughing episode.
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Common Threads: Prior Hysterectomies
Both women shared a common factor contributing to their injuries: defects resulting from previous hysterectomies, which involve the removal of the uterus.
In the 2025 incident, the patient had undergone a hysterectomy ten months prior and had shown no ensuing complications. However, she sought emergency care after experiencing acute abdominal pain.
Upon examination, medical professionals noticed a portion of her bowel protruding from her vagina. Emergency surgery revealed a weakness in her vaginal wall which had allowed the intestines to rupture through and exit her body.
Although the specific trigger for the woman’s injury remained unspecified, the case report’s authors indicated that a chronic cough or powerful coughing spell could be contributing factors.
After successfully repositioning the organs and surgically correcting the defect, the patient’s recovery was smooth, and she was discharged after five days.
Both women experienced small bowel evisceration through their vaginas, with one suffering from it after an intense coughing fit
She received a formal diagnosis of vaginal cuff dehiscence, which is the splitting open of a surgical site, accompanied by small bowel evisceration.
Understanding Vaginal Cuff Dehiscence
Vaginal cuff dehiscence is a recognized, albeit uncommon, complication arising from hysterectomies, affecting roughly 0.032 percent of patients post-pelvic surgery.
The statistical data regarding wound dehiscence remains limited. However, a study from 2014 suggested that nearly three out of every 100 individuals undergoing abdominal and pelvic surgical procedures might encounter this issue. This risk escalates to approximately 10 percent among elderly patients.
This condition can prove fatal in roughly 40 percent of patients due to significant blood loss, extended periods of intense pain, or trauma inflicted upon the exposed organs.
The 2011 Case: A Similar Occurrence
In the 2011 case, the patient visited the emergency department, reporting a violent coughing fit immediately followed by the sensation of her bowel protruding from her vagina. Approximately six inches of her intestines had moved outside her body.
For the previous three years, the woman had been dealing with a vaginal vault prolapse, a condition in which the upper portion of the vagina descends into the vaginal canal.
Her condition was being effectively managed by her primary care physician.
However, her situation grew increasingly complex, prompting a referral to a specialist. Regrettably, the evisceration took place before she could schedule an appointment.
Doctors conducted emergency surgery, successfully repairing the defect and repositioning her bowels.
The surgery was a success, and she was released six days later.
The official diagnosis was a ruptured vaginal vault leading to prolapse of the small bowel.
According to the authors of the case report, only 113 cases of small bowel prolapse through a ruptured vagina have been reported worldwide.
The mortality rate associated with vaginal evisceration is approximately six percent.
Treatment and Immediate Actions
Such injuries necessitate prompt surgical intervention to restore the organs to their correct positions and repair any wounds or structural flaws.
Until surgery can be performed, applying a sterile saline dressing over the exposed organs is crucial to maintain their moisture.