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Abdominal pain ranks as the predominant cause for emergency department consultations. Although rare, transvaginal evisceration of the small intestine necessitates immediate surgical intervention due to its potential to induce intestinal ischemia and peritonitis. Key risk factors include postmenopausal status, a history of gynecologic surgery, and heightened abdominal pressure. Clinical presentation typically involves pain and protrusion of intestinal contents or even abdominal viscera. Diagnosis relies on thorough clinical assessment, and treatment strategies should be tailored to each patient. Here, we describe the case of a 65-year-old female patient with a non-traumatic evisceration of the ileum, who had undergone total abdominal hysterectomy following anterior colpocele a year ago, subsequently necessitating exploratory laparotomy and repair of the vaginal ampulla., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Fuentes et al.)

Orbital conjunctival epithelial cysts have traditionally been excised, with the risk of leaving behind remnants that may result in recurrences. We present an 18-year-old male who complained of a poorly retained prosthesis three years after a primary evisceration and polymethylmethacrylate (PMMA) ball implant. We performed cyst aspiration and injection foam sclerotherapy for the cyst, which resolved completely in six weeks, allowing the prosthesis to be retained comfortably. Aspiration and injection of sclerosing agents may result in the collapse of the cyst along with fibrosis of their walls with obliteration of the lumen, resulting in complete resolution., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Thomas et al.)

Endogenous endophthalmitis is a very rare but potentially devastating intraocular inflammation resulting from hematogenous dissemination into the eye from a remote focus of infection. We present a case of a 49-year-old Vietnamese gentleman with underlying hypertension and ischemic heart disease who presented with sudden onset bilateral eye blurring of vision for five days associated with fever, chills, and rigors. He started to have a chesty cough with right-sided pleuritic chest pain for three days as well as shortness of breath, which developed one day prior to admission. Bilateral ocular examinations and B-scan ultrasonography were consistent with endophthalmitis. A systemic workup was performed and showed multiloculated liver abscess and right lung empyema seen radiologically. Bilateral eye vitreous tap and intravitreal antibiotic injection were performed. He underwent ultrasound-guided pigtail catheter insertion and drainage of the subcapsular and pelvic collection. Microbiological findings revealed Klebsiella pneumoniae infection obtained from vitreous and endotracheal aspirate samples. There were no cultures yielded from the intraabdominal collection and peripheral blood. The right eye infection rapidly progressed to panophthalmitis, which subsequently led to globe perforation despite prompt treatment and eventually required evisceration. Thus, despite culture-negative pyogenic liver abscess in a non-diabetic patient, a high index of suspicion, emergent radiographic evaluation, and prompt intervention and treatment are crucial in salvaging the globes., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Arjamilah et al.)

Evisceration is described as the removal of intra-abdominal organs outside the abdominal cavity after partial or complete dehiscence of an operative incision. Multiple organs have been reported in the literature as being eviscerated through a drain site. Zero point five per cent (0.5) to 1.2% of all cases include the small bowel. In most cases, evisceration occurs three to eight hours post-operation. This article reports a case of an eviscerated small bowel segment through a drain site, along with the drain six hours post-operative. To our knowledge, such a complication following open abdominal or laparoscopic surgery has not yet been reported. Due to the imminent risk of strangulation and subsequent necrosis of the eviscerated visceral organ, drain site evisceration requires immediate intervention., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Papatheodorou et al.)

Spontaneous rupture of an incisional hernia leading to the evisceration of the intra-abdominal organs is one of the malefic complications seen in these patients. In addition to its rarity, it gets accompanied by possible lethality in the form of incarceration, sequential strangulation, necrosis, and eventual gangrene. If not treated aptly, the clinical scenario could lead to a life-threatening condition with a delay in timely intervention. With less than 20 documented cases, herein, we report a 48-year-old female with a previous history of a midline laparotomy who presented to us with an acute spontaneous evisceration of the small bowel. The patient was immediately decided on surgical management with exploratory laparotomy, adhesiolysis, and primary repair of the abdominal wall defect. Postoperatively, the patient improved without any complications., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Das et al.)

Endogenous Klebsiella pneumoniae panophthalmitis commonly affects those with compromised immunity. The occurrence of this infection in healthy individuals is rare. We describe the case of a healthy adult who presented with endogenous Klebsiella pneumoniae panophthalmitis from an asymptomatic liver abscess. A 64-year-old, previously healthy gentleman presented with rapidly progressive left eye periorbital swelling and blurring of vision. He had a low-grade fever three days prior to the development of ocular symptoms, but otherwise no other systemic complaints. Visual acuity was light perception in the left eye, and ocular motility was restricted in all directions of gaze. Ocular examination revealed proptosis, severe conjunctival chemosis, hazy cornea, and fibrin deposition in the anterior chamber. The posterior segment could not be visualized. Ultrasound of the hepatobiliary system revealed an abscess in the right lobe of his liver. His blood cultures grew Klebsiella pneumoniae . Despite being treated with high-dose intravenous antibiotics, his eye condition deteriorated. Evisceration was performed when he developed scleral melting and globe perforation. We highlight the importance of a high index of suspicion of endogenous Klebsiella panophthalmitis as it can be easily missed in healthy adults. Early diagnosis and prompt management are needed to prevent morbidity and mortality from this devastating infection., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Chai et al.)

We describe a case of a poorly controlled diabetic patient with left endogenous panophthalmitis with orbital cellulitis and positive ocular culture of  Escherichia coli  with negative systemic workup and rare clinical presentation. Was misdiagnosed and mismanaged as acute angle-closure glaucoma. Despite medical treatment with intravenous antibiotics, the patient required evisceration of the left eye as a result of the delay in diagnosis and treatment. A high index of suspicion for endogenous endophthalmitis and awareness of the proper workup and different clinical presentations is needed to avoid vision and life-threatening consequences., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Hassanin et al.)

Intestinal stomas have been performed for hundreds of years for both benign and malignant disorders of the large and small bowel. Complications of stomas like stomal prolapse, parastomal hernia, and retraction are well-known. The evisceration of intra-abdominal contents is a very rare occurrence, carrying a high burden of morbidity. The etiology, timing, and treatment of this complication are not adequately described in the literature. We report two patients who were operated and in whom ostomy was fashioned; parastomal evisceration occurred in the early postoperative period in both cases. Both of these patients were operated emergently, and reduction of eviscerated contents followed by stoma refashioning was performed. One patient survived; whereas, the other patient who presented with septic shock expired due to multiorgan dysfunction syndrome. This report describes a rare and possibly fatal complication of ostomy and highlights the importance of meticulous operative technique in ensuring safety in this procedure., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2019, Kulkarni et al.)