Small bowel obstruction after caesarean section: an unusual complication of surgical haemostatic agent

An unusual case of small bowel obstruction (SBO) due to haemostatic gelatin sponge placed during caesarean delivery is presented. A primigravida in their 30s underwent caesarean delivery at 39 weeks, and developed symptoms of SBO from the second postoperative day. Given the worsening condition of the patient and increasing abdominal girth, CT of the abdomen and pelvis was done which revealed features of SBO. Due to no improvement despite conservative management for 3 days, the decision for surgical management was taken. Exploratory laparotomy revealed adhesive obstruction with haemostatic agent with a definitive transition point in the ileum. Adhesiolysis was performed between bowel loops adhered to a gelatin sponge placed on the hysterotomy incision. The postoperative period was uneventful and she was discharged after 5 days. Physical haemostatic agents should be used judiciously and adhesions due to these agents should be kept in mind in the differential diagnosis of patients with SBO or other abdominal symptoms in the early postoperative period.