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Prompt intervention avoided the need for bowel resection. The patient was discharged on postoperative day 5, commenced on topical vaginal oestriol cream and subsequent urogynaecological follow-up demonstrated a well-healed vault with no initial recurrence of vaginal prolapse. Conservative management was agreed following multidisciplinary team discussion. This case highlights the importance of considering transvaginal evisceration in postmenopausal women with previous pelvic surgery and radiotherapy and the potential use of vaginal oestrogen following repair of vaginal wall defects.<\/jats:p>","DOI":"10.1136\/bcr-2025-271038","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T13:00:23Z","timestamp":1789736423000},"page":"e271038","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Transvaginal small bowel evisceration after rectal cancer resection"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7505-6004","authenticated-orcid":false,"given":"Boluwatife Oladapo","family":"Ayantunde","sequence":"first","affiliation":[{"name":"Upper GI Surgery, Norfolk and Norwich University Hospital NHS Trust, Norwich, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanskriti","family":"Srivastava","sequence":"additional","affiliation":[{"name":"Norfolk and Norwich University Hospital NHS Trust, Norwich, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Seebah","sequence":"additional","affiliation":[{"name":"Colorectal Surgery, Norfolk and Norwich University Hospital NHS Trust, Norwich, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ami","family":"Mishra","sequence":"additional","affiliation":[{"name":"Colorectal Surgery, Norfolk and Norwich University Hospital NHS Trust, Norwich, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Simpson","sequence":"additional","affiliation":[{"name":"Obstetrics & Gynaecology, Norfolk and Norwich University Hospital NHS Trust, Norwich, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,18]]},"reference":[{"key":"2026091806001106000_19.9.e271038.1","doi-asserted-by":"crossref","unstructured":"Judkins SE , Biffl WL . 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