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Postpartum Multiple Colon Perforation after Cesarean Section in COVID-19 Patients: A Case Series
Monireh Mirzaie1, Sara Lotfi1, Zahra Yazdi1
1Department of Obstetrics and Gynecology, Clinical Research Development Unit, School of Medicine, Qom, Iran.
Insights
COVID-19 (coronavirus disease) is linked to gastrointestinal issues, including colon perforation in postpartum women after Cesarean section. Early detection and surgical intervention are crucial for successful management and recovery.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Obstetrics & Gynecology
Background:
- Gastrointestinal symptoms affect 50% of COVID-19 patients.
- Bowel abnormalities are common in COVID-19, with 31% showing bowel-wall disorder on CT scans.
Observation:
- Three postpartum women developed colon perforation post-Cesarean section during the COVID-19 pandemic peak.
- All patients tested positive for SARS-CoV-2 RNA.
Findings:
- Successful management involved early detection, laparotomy, and effective treatment.
- All three patients were discharged and followed up post-treatment.
Implications:
- Colon perforation is a potential complication of COVID-19, especially in postpartum women with surgical history.
- Abdominal imaging (ultrasound, X-ray) is recommended for postpartum women with abdominal distension, GI symptoms, or pain to prevent fetal complications.
Introduction:
Gastrointestinal symptoms are present in 50% of polymerase chain reaction (PCR)-positive COVID-19 patients. In addition, bowel abnormalities are a common finding of COVID-19, and bowel-wall disorder is reported in 31% of computed tomography images of COVID-19 patients.
Case History:
We report three postpartum cases with colon perforation after Cesarean section and positive PCR for SARS-CoV-2-RNA and during the main peak of COVID-19 pandemic, who were managed by early detection, laparotomy, and effective treatment and were discharged and followed up.
Conclusion:
A colonic perforation could be considered as one of the causes of abdominal pain especially in women with a past surgical history as well as patients with infectious diseases such as COVID-19. Therefore, abdominal and pelvic ultrasound or x-ray was strongly recommended for postpartum women with abnormal abdominal distension, gastrointestinal symptoms, and pain to prevent possible fetal complications.
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