From the Research
For abdominal distension after a cesarean section, an ultrasound (US) would be the best initial imaging study, as it plays a pivotal role in evaluating abdominal disease, has virtually no contraindications, and can provide useful diagnostic information in both hepatic and non-hepatic pathology 1.
Key Considerations
- The choice of imaging should consider the patient's clinical presentation, timing since surgery, and specific symptoms.
- Abdominal distension after C-section is often related to postoperative ileus, which typically resolves with conservative management including early ambulation, adequate pain control, and sometimes medications like metoclopramide.
- Persistent or worsening distension, especially when accompanied by fever, severe pain, or vomiting, requires prompt evaluation to rule out serious complications such as infection, obstruction, or bleeding.
Imaging Options
- Ultrasound (US) is a useful initial imaging technique due to its availability, lack of ionizing radiation, and ability to evaluate fluid collections or hematomas near the surgical site 1.
- Computed Tomography (CT) scan with contrast may be considered if US findings are inconclusive or concerning, as it provides more detailed information about potential complications like anastomotic leaks, abscesses, or hematomas 2.
- Magnetic Resonance Imaging (MRI) may also be useful in certain cases, but its use is limited by the presence of MRI "unsafe" implants and devices, and the risk of nephrogenic systemic fibrosis in patients with renal insufficiency 1.