Small bowel obstruction (sbo) following normal childbirth

Abstract

Small bowel obstruction (SBO) following normal childbirth is a rare condition with a high mortality rate. The symptoms are varied and nonspecific, including abdominal pain, abdominal distention, nausea, and vomiting, which means SBO has many differential diagnoses . Postoperative adhesions are the most common risk factor for SB. We present a case of SBO following normal vaginal delivery caused by an adhesion band leading to entrapment and volvulus of the ileum in a patient with a history of appendectomy and pelvic inflammatory disease (PID). A contrast-enhanced CT scan of the abdomen was instrumental in establishing the etiology and diagnosis of SBO. Surgical intervention was performed as the treatment. A 27-year-old woman, gravida 1 para 0, at 39 weeks of gestation, was referred by her obstetrician to the surgery department with complaints of vomiting since the onset of normal vaginal delivery. One day postpartum, her vomiting persisted. Her abdomen became distended and painful, and she was unable to pass gas. On physical examination, the patient appeared severely ill. She was hypotensive (BP: 94/62 mmHg), tachycardic (110 beats/min), tachypneic (26 breaths/min), and had an axillary temperature of 37.8°C.  The patient had a history of an appendectomy 15 years ago, vaginal discharge, irregular menstruation several months before pregnancy, painful periods, and nonspecific intermittent abdominal pain that became more frequent in the third trimester of pregnancy, intensifying as labor approached. A complete blood count showed leukocytosis (11.33 x 109/L) and hyponatremia (129.9 mmol/L).