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Early Post-cesarean Section Gangrenous Ileocecal Volvulus in a Primigravida: A Rare Postpartum Complication Case

Anteneh Girma Mengistu1, Nathanael Elias Temesgen1, Selamawit Kassahun Aweke2

  • 1Department of Surgery Addis Ababa University College of Health Sciences, Tikur Anbessa Hospital Addis Ababa Ethiopia.

Clinical Case Reports
|May 21, 2026
PubMed

Cecal volvulus is a rare cause of intestinal obstruction, especially in the postpartum period. It occurs when the cecum, terminal ileum, and ascending right colon twist around an axis, which leads to obstruction, ischemia, and possible gangrene. We report a rare case of early postcesarean gangrenous ileocecal volvulus in a 21-year-old mother, just two days after an emergency cesarean section. The patient showed right-sided abdominal swelling, pain, vomiting, and absence of bowel movements. Imaging showed dilated bowel loops with air-fluid levels, indicating a small-bowel obstruction. An exploratory laparotomy confirmed a 540° clockwise ileocecal volvulus with gangrenous changes, requiring resection and double-barrel ileocolostomy. The patient had a smooth recovery after the surgery. This case highlights the need to be alert for cecal volvulus in postpartum women who have sudden abdominal distention following a cesarean delivery, as early identification and quick surgical intervention are essential to avoid serious complications.

Keywords:
case reportcesarean section complicationileocecal regionintestinal obstructionpostpartum periodvolvulus

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