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Abdominal pain, distension and constipation after c-section. Could distal ileum be injured?

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Gastroenterologist, Surgical
Practicing since : 1989
Answered : 883 Questions
In a case of c-section, delivery was done on 28.7.2009 and discharged on 04.08.2009. She felt pain in abdomen, distension and constipation at the time of discharge and afterwards. On 08.08.2009 she was admitted in hospital and on laparotomy her distal ileum was found gangrenous and perforated. Faecal matter around 1.5 liter was found in peritoneal cavity.

1) Whether there is any possibility of damaging distal ileum during c-section?

2) If the laparotomy was not done well in time than whether it was fatal for her?

3) In such case a what are the expected consequences if proper treatment is not given to the patient?
Posted Wed, 20 Mar 2013 in Abdominal Pain
Answered by Dr. Ketan Vagholkar 2 hours later
Thanks for writing in.
1. The injury to the small intestine was undoubtedly caused at the time of the c section. This is evidenced by the fact that the patient never settled after the surgery. The injury should have been picked during her stay in hospital for the c section by way of abdominal signs. Meticulous care should have been exercised at the time of closure of the uterus. If the gynaecologist encountered difficulty at the time of closure he should have observed the patient closely during the postoperative period.

2. If the laparotomy was not done in time the patient would have gone into septicaemia and succumbed to it.

3. Mortality is the main sequelae if the perforation and gangrene are not picked or detected in time.

I hope this answers all your querries.
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