Background: Recent studies have established that intraperitoneal chemotherapy is associated with improved outcomes compared with intravenous treatment in patients with advanced, optimally cytoreduced ovarian cancer, but at the expense of increased toxicity. We present a case of vaginal evisceration during intraperitoneal chemotherapy for advanced ovarian cancer.
Case: Following an optimal cytoreduction including total hysterectomy for advanced ovarian cancer, a 63-year-old woman underwent intraperitoneal chemotherapy. On pelvic examination prior to her second cycle of chemotherapy, she was found to have vaginal evisceration of small bowel.
Conclusion: Intraperitoneal chemotherapy imparts an improved survival, but at the expense of increased toxicity. It is possible that the increased abdominal pressure during intraperitoneal chemotherapy contributes to the risk for vaginal evisceration. In patients planning on undergoing intraperitoneal chemotherapy, supracervical hysterectomy should be considered in appropriate candidates.