A Case of Cecal Perforation Due To Ogilvie's Syndrome after Cesarean Section

BACKGROUND AND OBJECTIVE: Ogilvie Syndrome is an acute, non-organic pseudo obstruction of the colon due to neurological dysfunction of the bowel, that can be happened after pelvic & gynecologic surgery.Perforation of the colon and peritonitis can be occur due to perfusion impairment of the colon wall, because of increased intraluminal pressure of the bowel. We here reported a case of this rare syndrome as it may have high mortality and morbidity if any delay be occurred. CASE REPORT: A 33 years old Female patient, presented with abdominal distention and obstipation and constipation 48 hours after her 2nd cesarean section delivery that accompanied with abdominal pain, fever and tachycardia and abdominal tenderness, regard less to conservative management. So she Underwent laparotomy with impression of peritonitis. Severe dilation of the cecum and ascending colon with perforation of the cecal wall was found known as Ogilvie syndrome. Right hemicolectomy and ileocolic anastomosis was done. A 33 years old Female patient, presented with abdominal distention and obstipation and constipation 48 hours after her 2nd cesarean section delivery that accompanied with abdominal pain, fever and tachycardia and abdominal tenderness, regard less to conservative management. So she Underwent laparotomy with impression of peritonitis. Severe dilation of the cecum and ascending colon with perforation of the cecal wall was found known as Ogilvie syndrome. Right hemicolectomy and ileocolic anastomosis was done. The patient was house arrested for 5 days in ICU of surgery. During this period, patient was treated with broad spectrum antibiotics, optimal hydration and nutritional support as PPN were performed. On the fifth day after surgery, a liquid diet was started for patient and bowel movement was established. After 10th day of surgery, the patient was discharged with good general appearance. In three months follow-up after surgery, there was no specific complication CONCLUSION: Proper and on-time diagnosis and management of the Ogilvie Syndrome, decreases the rate of mortality and morbidity of this emergent condition. It is important for the healthcare provider to know this critical condition and to have high clinical suspicion when deal with a patient with bowel obstruction symptoms after pelvic & gynecologic surgery.