Volume 11, Issue 2 (2026)
SJMR 2026, 11(2): 73-77 |
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Nateghi M R, Seyedi Moghadam N. Gastric Perforation and Peritonitis Following Cesarean Section: A Rare Case Report and Review of Diagnostic Challenges. SJMR 2026; 11 (2) : 4
URL: http://saremjrm.com/article-1-397-en.html
URL: http://saremjrm.com/article-1-397-en.html
1- Sarem Gynecology, Obstetrics and Infertility Research Center, Sarem Women’s Hospital, Iran University of Medical Science (IUMS), Tehran, Iran. & Sarem Cell Research Center (SCRC), Sarem Women’s Hospital, Tehran, Iran.
2- Sarem Gynecology, Obstetrics and Infertility Research Center, Sarem Women’s Hospital, Iran University of Medical Science (IUMS), Tehran, Iran.
2- Sarem Gynecology, Obstetrics and Infertility Research Center, Sarem Women’s Hospital, Iran University of Medical Science (IUMS), Tehran, Iran.
Abstract: (12 Views)
Introduction: Gastric perforation is a rare but life-threatening surgical emergency, and its occurrence during the post-cesarean period is exceptionally uncommon. Owing to its nonspecific clinical manifestations, the diagnosis may be delayed, potentially resulting in generalized peritonitis, sepsis, and a significant increase in maternal mortality. Therefore, awareness of this rare complication in patients presenting with unusual symptoms after cesarean delivery is of considerable clinical importance. Herein, we report a rare case of gastric perforation associated with peritonitis following cesarean section.
Case Presentation: A 31-year-old woman presented to the Emergency Department of Sarem Super Specialty Hospital, Tehran, five days after undergoing a cesarean section, with complaints of dyspnea, abdominal pain, and severe anorexia. On initial examination, her blood pressure was 94/50 mmHg, heart rate was 115 beats/min, and oxygen saturation was 94% on room air. She had no fever, and there were no signs of surgical site infection. Abdominal examination revealed mild abdominal distension, while abdominal ultrasonography demonstrated free intraperitoneal fluid (ascites). Based on the clinical and imaging findings, gastrointestinal perforation was suspected, and the patient underwent emergency laparotomy. Intraoperative findings confirmed gastric perforation with generalized peritonitis. Surgical repair of the perforation, peritoneal lavage, and appropriate supportive care were performed. The postoperative course was uneventful, and the patient was discharged in good general condition on January 2, 2026.
Conclusion: Although gastric perforation following cesarean section is an extremely rare complication, it should be considered in postpartum women presenting with persistent abdominal pain, abdominal distension, or unexplained gastrointestinal or respiratory symptoms. Maintaining a high index of clinical suspicion, prompt imaging evaluation, and timely surgical intervention are essential for reducing morbidity and improving patient outcomes. This case highlights the importance of considering gastrointestinal perforation in the differential diagnosis of acute abdomen after cesarean delivery and may increase clinicians' awareness, facilitating earlier diagnosis and management in similar cases.
Case Presentation: A 31-year-old woman presented to the Emergency Department of Sarem Super Specialty Hospital, Tehran, five days after undergoing a cesarean section, with complaints of dyspnea, abdominal pain, and severe anorexia. On initial examination, her blood pressure was 94/50 mmHg, heart rate was 115 beats/min, and oxygen saturation was 94% on room air. She had no fever, and there were no signs of surgical site infection. Abdominal examination revealed mild abdominal distension, while abdominal ultrasonography demonstrated free intraperitoneal fluid (ascites). Based on the clinical and imaging findings, gastrointestinal perforation was suspected, and the patient underwent emergency laparotomy. Intraoperative findings confirmed gastric perforation with generalized peritonitis. Surgical repair of the perforation, peritoneal lavage, and appropriate supportive care were performed. The postoperative course was uneventful, and the patient was discharged in good general condition on January 2, 2026.
Conclusion: Although gastric perforation following cesarean section is an extremely rare complication, it should be considered in postpartum women presenting with persistent abdominal pain, abdominal distension, or unexplained gastrointestinal or respiratory symptoms. Maintaining a high index of clinical suspicion, prompt imaging evaluation, and timely surgical intervention are essential for reducing morbidity and improving patient outcomes. This case highlights the importance of considering gastrointestinal perforation in the differential diagnosis of acute abdomen after cesarean delivery and may increase clinicians' awareness, facilitating earlier diagnosis and management in similar cases.
Article number: 4
Keywords: Cesarean Section, Gastric Perforation, Perforated Peptic Ulcer, Peritonitis, Postpartum Period, Acute Abdomen, Case Report.
Article Type: Case Report |
Subject:
Pregnancy Care
Received: 2026/07/2 | Accepted: 2026/07/18 | Published: 2026/07/30
Received: 2026/07/2 | Accepted: 2026/07/18 | Published: 2026/07/30
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