Cecal volvulus: A rare post-partum complication
| Autor: | Mohamed Amine Hannechi, Slim Khedhri, Khaled Neji, Ramzi Arfaoui, Mohamed Ferjaoui, Anis Haddad |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Pregnancy
medicine.medical_specialty biology Nausea business.industry Septic shock Cecal volvulus Case Report Postpartum period medicine.disease biology.organism_classification Gastroenterology digestive system Cesarean section delivery Abdominal mass digestive system diseases Caecum Internal medicine medicine Vomiting Surgery medicine.symptom business Complication |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| Popis: | Introduction and importance Cecal volvulus is a rare clinical condition. It is characterized by axial twist of caecum, terminal ileum and the ascendant right colon around their mesenteric pedicles. The main pathophysiologic mechanism is cecal hyper mobility associated to precipitating factor such as colonic tumor, abdominal mass or pregnancy. Cecal volvulus during pregnancy was reported, but it remains exceptional during postpartum period. Clinical presentation We report a case of cecal volvulus occurring in 37-year-old woman ten days after cesarean section delivery. She presented an acute abdominal pain associated to vomiting and nausea. X ray imaging and abdominal CT showed a large colonic obstruction, the caecum was dilated and located in the left hypochondrium. An open surgery was performed showing twisted bowels involving the caecum, the ileocecal junction and the right colon. There were necrotic areas on the colonic wall. Right hemicolectomy was performed with end to side ileo-colostomy. The evolution was marked by a serious septic shock causing patient's death. Clinical discussion Cecal volvulus is a rare condition. Its suggested mechanism associates cecal hyper mobility to a precipitating factor. Increased uterine volume may explain cecal volvulus during pregnancy. In post-partum period, it may be explained by rapid uterine size variation. Cecal volvulus diagnosis is challenging. In fact, its symptoms can be confused with post operative ileus after cesarean section delivery. Delayed management leads to worst prognosis. Conclusion Cecal volvulus during post-partum period is a rare condition, it may be serious in case of delayed diagnosis. Highlights • Cecal volvulus in post-partum period is a rare and serious condition. • Clinical presentation of cecal volvulus after cesarean section can be confused with post operative ileus. • Abdominal CT is useful in case of atypic ileus clinical presentation. • Surgery is the corner stone of cecal volvulus management. • Worst prognosis is associated with delayed diagnosis. |
| Databáze: | OpenAIRE |
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