PDF(Pubmed)
Abstract：
Background and Objectives: Every surgical procedure has the possible risk of complications, and caesarean sections (CSs) are no exception. As CS rates are increasing worldwide, being familiar with rare but possible complications has become extremely important. Case report: We present a case of 25-year-old nulliparous patient who came to our hospital with twin pregnancy for a scheduled induction of labour. An urgent CS was performed due to labour dystocia. On the second postoperative day, the patient started to complain about pain in the epigastrium, but initially showed no signs of bowel obstruction, passing gas, and stools, and could tolerate oral intake. After a thorough examination, an early postoperative complication-small-bowel strangulation at the incision site-was diagnosed. Small bowels protruded in between sutured rectus abdominis muscle causing a strangulation which led to re-laparotomy. During the surgery, there was no necrosis of intestines, bowel resection was not needed, and abdominal wall repair was performed. After re-laparotomy, the patient recovered with no further complications. Conclusions: Although there are discussions about CS techniques, most guidelines recommend leaving rectus muscle unsutured. This case demonstrates a complication which most likely could have been avoided if the rectus muscle had not been re-approximated.
摘要：
背景与目的:每一个手术都有可能发生并发症的风险,剖腹产（CSs）也不例外。随着全球CS率的增加，熟悉罕见但可能的并发症变得极其重要.病例报告：我们介绍了一例25岁的未产患者，他因双胎妊娠来到我们医院进行预定的引产。由于难产，进行了紧急CS。在术后第二天，病人开始抱怨上腹部疼痛，但最初没有肠梗阻的迹象，通过的气体,和凳子，并且可以耐受口服摄入。经过彻底检查,诊断为术后早期并发症-切口部位小肠绞窄.小肠在缝合的腹直肌之间突出，导致绞窄，导致再次剖腹手术。在手术过程中,没有肠坏死,不需要肠切除术，并进行腹壁修复。再次剖腹手术后,患者康复，无进一步并发症。结论：虽然有关于CS技术的讨论，大多数指南建议不缝合直肌。这种情况表明，如果没有重新接近直肌，很可能可以避免并发症。
