EDITORIAL COMMENT": We accepted this paper for publication to warn readers that coitus-induced tears to the posterior fornix of the vagina can involve peritoneum and bowel. The authors claim this injury is common in India and at our request provided the information that in 1995 they treated a total number of 7 patients with coitus-induced vaginal tears in their hospital which has some 4,000 deliveries per year. The authors noted that the incidence of this injury is much higher than these figures would indicate because ‘people do not like young girls being asked questions by male medical graduates and for this reason prefer to go to private hospitals for the problem of coital tears’. They stated that for Indians coital tears are relatively common and any obstetrician would see 4–5 cases every 1–2 years’. We have previously published information from Papua New Guinea describing 13 cases of laceration to the posterior fornix of the vagina from voluntary intercourse seen over a period of 3 years at the Port Moresby General Hospital (A), and 13 cases of women with coital injury admitted with haemorrhagic shock requiring resuscitation with blood transfusion seen over a period of 4 years from the Nehru Hospital (B). Anate (C) has reported the details of 36 cases of vaginal trauma due to intercourse seen over a 6-year period in Nigeria. All of these papers stress the frequent involvement of the posterior fornix of the vagina in these coitus-induced injuries.
Summary: A rare cause of secondary peritonitis due to coital tear is presented. The correct diagnosis can be made by a detailed history and gynaecological examination. Prompt surgical management is mandatory to prevent grave prognosis.