Publication:

Non-obstructive cecal perforation in post-partum period: a rare case report

A primi-para patient presented in emergency, ten days after normal vaginal delivery, with acute abdominal pain, low grade fever and constipation. Clinical examination revealed poor general condition, signs of dehydration, tachycardia, hypotension, guarding and rigidity all over the abdomen. Investigations were suggestive of perforation and peritonitis. Contrast enhanced CT confirmed the presence of around 800 ml of free fluid. After initial resuscitative measures, patient is taken up for laparotomy in view of acute abdomen. Intra-operatively around 1 l of purulent fluid drained. Exploration of the bowel revealed a large cecal perforation. Repair was carried out with rescue colostomy. Her post-operative period was un-eventful, she showed steady improvement and was discharged in a stable condition with colostomy in situ. The colostomy was closed after 12 weeks.