A case of small bowel obstruction occurring secondarily after uterine compression suture for intractable uterine bleeding during cesarean section due to adherent placenta

DOI
  • Tsuge Shiori
    Department of Obstetrics and Gynecology Gifu Prefectural Tajimi Hospital
  • Shibata Mayu
    Department of Obstetrics and Gynecology Gifu Prefectural Tajimi Hospital
  • Nagai Takashi
    Department of Obstetrics and Gynecology Gifu Prefectural Tajimi Hospital
  • Shinone Sanae
    Department of Obstetrics and Gynecology Gifu Prefectural Tajimi Hospital
  • Matsukawa Satoshi
    Department of Obstetrics and Gynecology Gifu Prefectural Tajimi Hospital
  • Nakamura Hiromi
    Department of Obstetrics and Gynecology Gifu Prefectural Tajimi Hospital

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  • 子宮圧迫縫合術後，縫合糸による腸閉塞を発症した1例

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Abstract

<p> Recent efforts have made uterine compression suture（UCS）a feasible option for management of intractable bleeding during cesarean section complicated with abnormal placentation. Reported complications after UCS include infection, necrosis and secondary fertility. However, small bowel obstruction after UCS has never been reported.</p><p> Herein, we report a case of small bowel obstruction secondarily developed after cesarean delivery with UCS. A 31 years-old woman with previous history of two cesarean section conceived by in vitro fertilization and embryo transfer. At 38 weeks of gestation, elective cesarean section was performed. During procedure, UCS using Monodiox® was performed for difficult hemostasis due to retained placenta. Eighteen days after cesarean section, small bowel obstruction was diagnosed when she presented with severe abdominal pain. After failed conservative management with placement of ileus tube, laparotomy was chosen, eventually showing that coiling of thread of Monodiox® around small bowel at several portions is the cause of ileus. After removal of the coiled thread, recurrence of ileus was not observed. In summary, in a case managed by UCS, potential risk of secondary development of ileus should be cautioned to achieve early prompt management.</p>

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