[Vaginal eviscentration with secondary strangulation of small bowel]. / Wytrzewienie przez pochwe z wtórnym zadzierzgnieciem jelita cienkiego.

A case of 81 year old patient with eviscentration through vagina with a strangulation of small bowel was described. The woman was treated gynecologically and underwent surgery previously. The eviscentration occurred 21 months after last surgery and was connected with high abdominal pressure during defecation. Woman was qualified to an urgent laparotomy, and the hole about 15 mm length in vaginal posterior vault was found. Through the hole passed small bowel which was strangulated. The bowel was removed to the abdominal cavity and during its control no necrosis was found. The color and vascularity return to normal and right peristaltic was noticed. The hole in parietal peritoneum was closed by a continuous suture. The hole in vagina was also closed by the continuous suture from the perineal side. Woman in good general condition was discharged from hospital in the 13th day after surgery.

[Eventrations--the prospective analysis of risk factors of eventrations patients after laparotomy treated in 8 surgical departments of Podkarpacie District]. / Wytrzewienia--prospektywna analiza czynników ryzyka wytrzewien u chorych po laparotomiach, leczonych w 8 osrodkach chirurgicznych Województwa Podkarpackiego.

UNLABELLED: Eventration is still a major surgical problem. Although not very common, but may cause serious complications leading to patient's death. It is observed in 0.2-7% (average 2%) of all the laparotomy. The aim of the study was the analysis of risk factors and frequency of eventrations. MATERIAL AND METHODS: The study was performed in 8 surgical departments in Podkarpacie district since April 2004 till March 2005. RESULTS: During the analysed period there were 4360 laparotomies performed. Eventration was observed in 23 cases (0.52% of all laparotomies performed)--30.5% of the afflicted were females; males constituted the remaining 69.5%. Patients over the age of 70 represented approximately 70% of all of the eventration cases. The most common risk factors were: ASA (American Society of Anesthesiologists) III or higher, low plasma protein level, operations on the large bowel, abdominal midline incision and emergency operations. Occurring eventrations were aseptic, late, III degree. CONCLUSIONS: (1) The frequency of eventrations in hospitals of podkarpacie district is low (0.52% of all laparotomies indicates good technique of wound suture after laparotomy). (2) The eventrations were associated with the following risk factors: age over 70, ASA greater or equal III, low plasma protein level, operations on the large intestine, midline incision and emergency surgeries.