An Obstetric Perspective on Functional Bowel Obstruction After Cesarean Section: A Case Series

Abstract

Ogilvies syndrome (OS) and paralytic ileus are two types of functional bowel obstructions well known in obstetrics. Cesarean section and spinal anesthetic have been reported as etiological factors. OS is rare; however, associated morbidity and mortality rates are high. We report on three patients whose post-cesarean section course was complicated by a functional bowel obstruction. Two of the patients exhibited signs of imminent perforation from cecal dilation and required major surgical intervention. The pathophysiology of OS and paralytic ileus and their respective management are discussed based on a review of the literature. A new approach to the management of functional bowel obstructions after cesarean section is offered from an obstetric perspective. Identification of cecal dilation is the key. We suggest prompt measurement of the cecum with an abdominal X-ray followed by surgical review and intervention in symptomatic patients with a cecal diameter equal to or greater than 10 cm.




J Clin Gynecol Obstet. 2016;5(1):53-57
doi: http://dx.doi.org/10.14740/jcgo390w