Case ReportSmall Bowel Obstruction After Vaginal Hysterectomy and Bilateral OophorectomySchmitt, Timothy MD; Huguet, Kevin MD; Pettit, Paul MDAuthor Information From the Department of General Surgery and Gynecologic Surgery, Mayo Clinic, Jacksonville, Florida. Reprints: Timothy Schmitt, MD, Department of General Surgery, Mayo Clinic Jacksonville, 4500 San Pablo Road, Jacksonville, FL 32224. E-mail: Schmitt.email@example.com Journal of Pelvic Medicine and Surgery: July-August 2003 - Volume 9 - Issue 4 - p 193-194 doi: 10.1097/01.spv.0000088401.76225.fb Buy Metrics AbstractIn Brief Small bowel obstruction is an extremely rare complication after vaginal hysterectomy. Currently, there are no reported cases of small bowel obstruction as a complication of a vaginal hysterectomy. We report a case of a 49-year-old woman who presented with epigastric abdominal pain 10 days after a vaginal hysterectomy. Initial work up included abdominal films, white blood cell count, and nasogastric tube decompression. Exploratory laparotomy revealed a closed loop obstruction of the small bowel. The mesentery of the closed loop was centered around a staple, which we hypothesized served as a focal point for the mesenteric rotation. The small bowel obstruction resolved after the closed loop was relieved and the staple removed. The patient recovered well postoperatively and was discharged home on postoperative day 4. It is postulated that the staple was inadvertently discharged from the endo-GIA stapling device during the vaginal hysterectomy. We present this case and a review of the literature. Small bowel obstruction following vaginal hysterectomy, unusual mechanism with review of the literature. © 2003 Lippincott Williams & Wilkins, Inc.