A case report of cecal perforation due to Ogilvie syndrome after cesarean section

Document Type : Case report

Authors

1 Associate professor, Department of General Surgery, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

2 Resident, Department of General Surgery, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Abstract

Introduction: Ogilvie syndrome is a non-mechanical and acute colon obstruction that can occur in women after pelvic surgery and can lead to cecal perforation if not be early diagnosed. Therefore, familiarity with this syndrome and its symptoms can help to prevent its complications. In this study, we report a case of ogilvie syndrome which resulted in perforation of the cecum and underwent right hemicolectomy.
Case presentation: A 42-year-old woman after 72 hours of cesarean section (second turn) progressively had abdominal distension, obstipation flatulence and abdominal pain. At admission, there were signs of peritoneal stimulation, leukopenia, and electrolyte imbalance. The patient underwent laparotomy and the finding was cecal perforation. Right hemiclectomy was performed. Due to the severe contamination of the abdominal cavity, double barrel ileostomy was done. The patient was sent to surgical intensive care unit and treated with broad-spectrum antibiotics for 3 days. Subsequently, she was transferred to the ward and after the defication, the fluids regimen was started for the patient and discharged from the hospital 12 days after the surgery. And 3 months later she underwent ileostomy closure and did not have any particular medical problems in the subsequent follow-ups.
Conclusion: Familiarity with ogilvie syndrome symptoms, including distension and bloating and obstipation, should always be considered by the physicians and personnel. It may be important especially in the presence of a recent history of pelvic surgery, because early diagnosis of this syndrome can be helpful in preventing its complications and mortality.

Keywords


  1. Fatnassi R, Mkhinini I, Abdelkefi MS, Torki E, Hammami S, Barhoumi MH. Ogilvie’s Syndrome: A Caesarean Section Complication (A two cases report and review of the literature). EC Gynaecol 2015; 1(1):35-40.
  2. Saha AK, Newman E, Giles M, Horgan K. Ogilvie’s syndrome with Cecal Perforation after Caesarean Section: A case Report. J Med Case Reports 2009; 3:6177.
  3. Moons V, Goremans G, Tack J. An update on acute colonic pseudo-obstruction (Ogilvie's syndrome). Acta Gastroenterol Belg 2003; 66(2):150-3.
  4. Mainguy Le Gallou C, Eboue C, Vardon D, Von Theobald P, Dreyfus M. [Ogilvie's syndrome following cesarean section: Just think! Report of two cases and review of the literature]. J Gynecol Obstet Biol Reprod (Paris) 2011; 40(6):557-63.
  5. Ben Ameur H, Boujelbene S, Beyrouti MI. [Treatment of acute colonic pseudo-obstruction (Ogilvie's syndrome). Systematic review]. Tunis Med 2013; 91(10):565-72.
  6. Kamali A, Barat Sh, Asghari Y. A Case of Cecal Perforation Due To Ogilvie's Syndrome after Cesarean Section. Journal of Babol University of Medical Sciences (JBUMS) 2016; 18(10):65-69.
  7. Basirat Z, Kashifard M, Bouzary  Z. A Case Report of Colonic Pseudo-Obstruction (Ogilvies Syndrome) After Cesarean Delivery. Scientific Journal of Kurdistan University of Medical Sciences 2005; 8(2):15-21.
  8. ASGE Standards of Practice Committee, Harrison ME, Anderson MA, Appalaneni V, Banerjee S, Ben-Menachem T, et al. The role of endoscopy in the management of patients with known and suspected colonic obstruction and pseudo-obstruction. Gastrointest Endosc 2010; 71(4):669-79.
  9. Vanek VW, Al-Salti M. Acute pseudo-obstruction of the colon (Ogilvie's syndrome). An analysis of 400 cases. Diseases of the Colon & Rectum 1986; 29(3):203-10.
  10. Ben Ameur H, Boujelbene S, Beyrouti MI. [Treatment of acute colonic pseudo-obstruction (Ogilvie's Syndrome). Systematic review]. Tunis Med 2013; 91(10):565-72.