Cecal perforation due to paralytic ileus following primary caesarean section.
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.
Laskin
Matthew D
MD
Department of Obstetrics and Gynaecology, St. Michael's Hospital, University of Toronto ON.
Tessler
Karen
K
Kives
Sari
S