Acute Intestinal Obstruction in the Post Partum Perioda Case Report

Abstract

Introduction: Bowel obstruction rarely complicates pregnancy; however, it is a life-threatening complication for both mother and child. This is a diagnostic and therapeutic emergency that must be and discussed in front of any digestive symptomatology. We report a case of hail volvulus complicating childbirth. Observation: A 26-year-old primigravida, who gave birth vaginally, presented an abdominal pain on Day 8 of the postpartum period. The onset of symptoms went back to Day 6  by the installation of an incomplete shutdown table for materials and gases. An exploratory laparotomy revealed a volvulus over the common small bowel mesentery with extensive intestinal necrosis. Surgical treatment consisted of devolvulation with resection of the necrotic hail segment, terminolateral anastomosis and large peritoneal toilet. Discussion: Diagnosing the cause of an occlusion is difficult in the immediate postpartum period. The enlargement of the abdomen and the difficulty in obtaining abdominal signs (due to the loss of tone of the abdominal wall) may mask clinical signs. Conclusion: Bowel obstruction rarely occurs in the postpartum period but it’saccompanied by high maternal morbidity and mortality often due to delayed diagnosis and treatment. Through the study of this clinical case, we propose to review the data in the literature and initiate the general principles of management and treatment.