Unusual lower genital tract injury caused by bull's horn: prolapse of small intestine through vagina-first case report in literature.

摘要

A 90-year-old multiparous post menopausal lady presented to the emergency department in shock with history of injury to perineum by a bull's horn. She was a known case of utero-vaginal prolapse and was not on any treatment. She was hit by a bull and presented to us 48 h later. The woman had poor health, asthenic build, and senile atrophic vagina. On examination, whole of the small intestine was lying outside introitus as shown in Fig. 1. Immediately the patient was prepared for surgery. Intraoperatively she was found to have laceration of cervix and anterior vaginal wall, around 6 cm in length. There was no vulvar haema-toma and no injury to bladder or bowel. After reposition of bowel into abdomen, she was found to have complete utero-vaginal prolapse. Decision to only repair the laceration was taken as the patient was already in septic shock. Cervix and vagina were repaired and the patient was shifted back to emergency ward.