Ogilvies Syndrome With Caecal Perforation Following Caesarean Section: A Case Report

Abstract

A 33-year-old healthy Caucasian woman underwent an emergency caesarean section at term for cephalopelvic disproportion. She developed abdominal distension and pain on first post operative day (POD) and was diagnosed clinically as having paralytic ileus. She refused an abdominal x-ray. Her condition improved with conservative management and she managed to pass flatus and have a bowel movement. She was discharged against medical advice on the sixth postoperative day. She presented to the emergency department on 14th day post delivery with acute abdomen. Diagnosis of perforated viscus was made on abdominal x-ray. She underwent an emergency laparotomy. At laparotomy, a perforation in her caecum was found and a hemicolectomy and loop ilieostomy was performed. Unfortunately her postoperative recovery was complicated by wound dehiscence secondary to infection. She recovered and was discharged home 39 days after the emergency laparotomy. Ogilvies syndrome can often be missed because the patient demonstrates signs of resolving ileus by passing flatus or having a bowel movement and have normal bowel sounds. Radiological confirmation of resolving ileus should be carried out if clinically the patients abdomen is still distended. Timely recognition may prevent the complication of perforated caecum, which can occasionally prove fatal.




J Med Cases. 2013;4(4):230-233
doi: https://doi.org/10.4021/jmc1042e