Adynamic ileus and acute colonic pseudo-obstruction occurring after cesarean section in patients with massive peripartum hemorrhage.
The clinical histories (including radiographs) of 4 patients who suffered from significant adynamic ileus or acute colonic pseudo-obstruction after cesarean section are presented. The main manifestations were vomiting, severe colicky pain, and abdominal distension. These can occur immediately after or within 2 days of the operation. Based on our experience, the risk factors for the development of adynamic ileus are significant peripartum hemorrhage leading to unstable hemodynamic status, severe constipation, use of meperidine for pain relief, and overt bowel manipulation. Mild enema and metoclopramide seem to be helpful in facilitating its resolution. Here, we examine how to differentiate mechanical bowel obstruction from adynamic ileus and look at how to prevent the occurrence of adynamic ileus while minimizing its severity and shortening its clinical course.
Cho
Fu-Nan
FN
Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, R.O.C. fncho@isca.vghks.gov.tw
Liu
Cheng-Bin
CB
Li
Ju-Yueh
JY
Chen
San-Nung
SN
Yu
Ken-Jen
KJ
D000208:Acute Disease; D000328:Adult; D002585:Cesarean Section; D003112:Colonic Pseudo-Obstruction / Q000209:etiology*; D005260:Female; D006470:Hemorrhage / Q000150:complications*; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology*; D007744:Obstetric Labor Complications; D011247:Pregnancy