What is the incidence of small bowel obstruction after cesarean section (C-section)?

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From the Research

Small bowel obstruction after a C-section is a rare complication, occurring in approximately 0.1% to 0.2% of cases, as reported in the most recent study 1. While rare, it's essential to be aware of the risk and symptoms. The most common timeframe for this complication is within the first 30 days after surgery, but it can occur later as well. Symptoms to watch for include severe abdominal pain, nausea, vomiting, bloating, and inability to pass gas or have a bowel movement. The risk is slightly higher for C-sections compared to vaginal deliveries due to the abdominal surgery involved. Factors that can increase the risk include previous abdominal surgeries, adhesions, and certain surgical techniques, such as the use of haemostatic agents 1. If symptoms occur, seek medical attention immediately. Treatment may involve nasogastric tube decompression, IV fluids, and close monitoring. In severe cases, surgical intervention may be necessary, as seen in the case report of a patient who developed SBO due to a haemostatic gelatin sponge placed during caesarean delivery 1. To reduce risk, early mobilization after surgery, proper hydration, and a gradual return to normal diet are recommended. Adhering to post-operative care instructions is crucial for optimal recovery and minimizing complications. Additionally, the judicious use of physical haemostatic agents and awareness of potential adhesions due to these agents can help prevent SBO in the early postoperative period 1.

Some key points to consider:

  • The incidence of SBO after C-section is very low, but it can be a severe complication if not recognized and treated promptly.
  • Adhesions represent a significant cause of SBO after C-section, and the use of haemostatic agents can increase this risk.
  • Laparoscopic management of SBO after C-section is a feasible option in selected patients, but conversion to open surgery may be necessary in cases with dense adhesions or technical difficulties 2.
  • A high index of suspicion and prompt diagnosis are essential for effective management of SBO after C-section.

References

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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