title: Cecal perforation due to paralytic ileus following primary caesarean section.
abstract: BACKGROUND
  Reports of cecal perforation complicating a Caesarean section postoperatively are very uncommon. Cecal perforations often are due to an antecedent bowel obstruction.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Obstetrics and Gynaecology, St. Michael's Hospital, University of Toronto ON.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Laskin
authors.forename: Karen
authors.initials: K
authors.lastname: Tessler
authors.forename: Sari
authors.initials: S
authors.lastname: Kives