Cecal perforation due to paralytic ileus following primary caesarean section
Matthew D Laskin1, Karen Tessler, Sari Kives
1Department of Obstetrics and Gynaecology, St. Michael's Hospital, University of Toronto ON.
Background:
Reports of cecal perforation complicating a Caesarean section postoperatively are very uncommon. Cecal perforations often are due to an antecedent bowel obstruction.
Case:
A 39-year-old primigravid woman presented with obstructed labour at a cervical dilatation of 6 cm. An uncomplicated Caesarean section was performed. Postoperatively, the patient developed signs consistent with a bowel obstruction and was managed conservatively. A perforated viscus was confirmed via imaging on the third and fourth postoperative days. The patient underwent laparotomy with resection of a perforated cecum, and she recovered well.
Conclusion:
Although uncommon after a Caesarean section, cecal perforation should be suspected if a patient presents with symptoms of a prolonged bowel obstruction. Early identification and prompt imaging are the mainstays of treatment for these patients.
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