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Peptic Ulcer Perforation After Cesarean Section; Case Series and Literature Review Publisher Pubmed



Shirazi M1, 2 ; Zaban MT3 ; Gummadi S3, 4 ; Ghaemi M1, 5
Authors
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Authors Affiliations
  1. 1. Maternal Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Breast Feeding Research Center, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Radiology, Thomas Jefferson University, Philadelphia, PA, United States
  4. 4. Department of Surgery, Lankenau Medical Centre, Wynnewood, PA, United States
  5. 5. Kamali Hospital, Alborz University of Medical Sciences, Karaj, Tehran, Iran

Source: BMC Surgery Published:2020


Abstract

Background: Peptic ulcer perforation in the early post-cesarean period is rare but may result in maternal mortality. Case presentation: Four cases of post-cesarean peptic ulcer perforation are presented. In all four patients, presentations include peritoneal signs such as acute abdominal pain and progressive distention, hemodynamic instability and intraperitoneal free fluid by ultrasound. Laparotomy and repair were done in all 4 cases. There were 2 maternal deaths. We also have reviewed English literature for the similar cases reported from 1940 to March 2019. Conclusion: New onset tachycardia, abdominal pain and progressive distension after cesarean section without congruent changes in hemoglobin should raise concerns for intra-abdominal emergencies including perforated peptic ulcer. Early use of ultrasound should be considered to assist in diagnosis. Coordinated care by an obstetrician and a general surgeon is necessary in presence of any unusual postoperative abdominal pain. Early recognition of the disease is imperative to limit the surgical delay and to improve the outcomes. © 2020 The Author(s).