DOI: 10.5811/westjem.2015.2.25766

A 61-year-old female presented to the emergency department complaining of constipation and vaginal bulge with valsalva 89 days after a robotic-assisted hysterectomy. The patient had intercourse three days prior to presentation and experienced postcoital abdominal discomfort with vaginal bleeding. She denied any other trauma. She had no other complaints and denies fevers, chills, nausea, vomiting, abdominal distension, or constipation. Physical exam revealed exposed bowel protruding through the vaginal cavity. DISCUSSION This patient had an impressive amount of evisceration through the dehisced vaginal cuff (Figure). Vaginal cuff dehiscence is a rare but emergent complication of gynecologic operations. A full thickness dehiscence can be complicate