Health Warning: Coughing Dangers This Allergy Season

Doctors are raising alarms about the risks of severe coughing during this allergy season.

A recent case report detailed the experience of a 61-year-old woman from Taiwan who faced a rare condition known as bowel evisceration, where parts of the intestines protrude outside the body. It’s an alarming situation, particularly because it’s not entirely common. For instance, there was a similar incident involving an 86-year-old woman from the UK back in 2011. She also developed evisceration after suffering an intense coughing fit, and this led to parts of her small bowel protruding through her vagina.

Both instances were notably linked to previous hysterectomies, suggesting that such surgeries can sometimes lead to serious outcomes. In the Taiwanese woman’s case, she had undergone a hysterectomy around ten months prior, and although she initially had no complications, she eventually sought emergency care due to abdominal pain.

Upon examination, doctors discovered a part of her bowel protruding from her vagina. During surgery to repair the damage, they identified a defect in her vaginal wall, which had allowed the intestines to break through. It’s somewhat puzzling, really— while the specific causes weren’t clearly defined, the authors of the case indicated that chronic or intense coughing could be significant risk factors.

After her surgery to reposition the organs and address the defect, she seemed to recover well and was discharged just five days later.

She was diagnosed with vaginal cuff dehiscence, which, while a recognized complication of hysterectomy, is quite rare— it affects about 0.032 percent of patients post-pelvic surgery. Notably, a 2014 study indicated that up to three in every 100 individuals who have had abdominal or pelvic surgeries might face this issue, with the risk climbing to ten percent among elderly patients.

This complication could be quite serious, leading to complications like severe blood loss or organ damage.

Regarding the UK case from 2011, the individual reported to emergency services after experiencing a severe coughing episode and discovering the protrusion of her intestines—specifically six inches of them—through her vagina. She had been managing a vaginal vault prolapse, but it escalated before she could see a specialist.

Following emergency surgery, doctors mended the defect and returned her bowels to their proper place. The procedure was thankfully successful, and she was released six days later.

Her official diagnosis was a ruptured vaginal vault that led to the small bowel prolapse. According to the authors of the case, only 113 cases of small bowel prolapse via ruptured vagina have ever been documented worldwide. This kind of injury carries a mortality rate of about six percent, underscoring the serious nature of such conditions. When they happen, surgical intervention is critical to replace the organs and close any openings.

Exposed organs should also be covered with a sterile saline solution to keep them moist until surgery can be done.