Background

Vaginal laceration during coitus is not a rare occurrence; however, vaginal perforation from coitus is uncommon and occurs in less than 1% of nonobstetric genital tract injuries. Limited case reports exist discussing the recognition and management of vaginal perforation. Previously described management is commonly performed with laparotomy.

Case

We report a case of postcoital vaginal laceration and posterior fornix perforation in an adolescent with hemoperitoneum, pneumoperitoneum, and subsequent hypovolemic shock, and describe a laparoscopic approach for repair.

Summary and Conclusion

Vaginal perforation with subsequent peritonitis and hemodynamic instability is a rare outcome in an adolescent who presents to the emergency department with pain or bleeding in the setting of recent penile intercourse. Delays in recognition can lead to further patient compromise, with potential morbidity or mortality. In this patient cohort, we suggest maintaining a high clinical suspicion for this sequela, and a low threshold for surgery with perforations greater than 1 cm. In the event that surgical management is warranted, we recommend a laparoscopic approach to increase visibility and to improve postoperative outcomes.

中文翻译：

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腹腔镜方法治疗伴有腹膜炎和低血容量性休克的青少年性交后阴道穿孔。

背景

在性交期间发生阴道裂伤的情况并不罕见。然而，来自性交的阴道穿孔并不常见，发生在少于1％的非产科生殖道损伤中。目前，关于阴道穿孔的识别和处理的病例报告很少。先前描述的处理通常是通过剖腹手术进行的。

案件

我们报告了一名伴有腹膜，气腹和随后的低血容量性休克的青少年的性交后阴道撕裂和后穹ni穿孔，并描述了腹腔镜修复方法。

总结与结论

阴道穿孔伴随后的腹膜炎和血液动力学不稳定是在青少年中的罕见结果，在最近的阴茎性交中，该患者向急诊科表现出疼痛或出血。识别的延迟会导致患者进一步的折衷，并可能导致发病或死亡。在该患者队列中，我们建议对此后遗症保持较高的临床怀疑，而穿孔大于1 cm的手术阈值应较低。如果需要进行外科手术治疗，我们建议采用腹腔镜方法以增加可见度并改善术后结果。