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[Spontaneous cecum perforation following cesarean section]
1Geburtshilflich-Gynäkologische Abteilung des Universitätsklinikums Rudolf-Virchow/Wedding, Berlin.
There is a certain risk of paralytic distension of the bowel, especially of the coecum, during the initial post-operative days following caesarean section. As can be seen from the overview presented, the possible result is spontaneous perforation of the coecum, which frequently has lethal consequences. Early differential diagnostic consideration for a mother exhibiting early warning post-caesarean symptoms can be life saving. We would recommend as prophylaxis early bowel stimulation with a laxative already on the second day following surgery. By distension of the coecum over 9 cm, as measured by sonography, decompression using either coloscopy or even coecostomy is recommended. Ischemic damage of the intestinal wall, as a result of excessive distension, is the main etiological factor for spontaneous perforation. The declining post partum oestrogen levels and resulting decreased parasympathetic tone, as well as the preceding anaesthesia account for the paralytic bowel symptoms.
There is a certain risk of paralytic distension of the bowel, especially of the coecum, during the initial post-operative days following caesarean section. As can be seen from the overview presented, the possible result is spontaneous perforation of the coecum, which frequently has lethal consequences. Early differential diagnostic consideration for a mother exhibiting early warning post-caesarean symptoms can be life saving. We would recommend as prophylaxis early bowel stimulation with a laxative already on the second day following surgery. By distension of the coecum over 9 cm, as measured by sonography, decompression using either coloscopy or even coecostomy is recommended. Ischemic damage of the intestinal wall, as a result of excessive distension, is the main etiological factor for spontaneous perforation. The declining post partum oestrogen levels and resulting decreased parasympathetic tone, as well as the preceding anaesthesia account for the paralytic bowel symptoms.