Difficulty in predicting intra‐abdominal adhesion before cesarean section: A case report

Abstract

Severe adhesions between the bladder and uterus necessitated an atypical incision in the cesarean section of a woman with endometriosis. This could not be predicted with pre‐surgery MRI. No methods in the literature are able to predict adhesions with true certainty; it is therefore still difficult to diagnose intra‐abdominal adhesions.

Iatrogenic Ureteral and Colonic Injuries During Emergency Cesarean Section: A Lesson Learned from a Surgical Catastrophe – A Case Report

“…Women with a history of endometriosis have an increased risk of obstetric complications, and adhesions caused by endometriosis are difficult to predict preoperatively. 5 In our patient, there was no history of previous surgery; however, incidental lesions of endometriosis were discovered during C-section that may cause severe adhesion. 5 …”

“… 5 In our patient, there was no history of previous surgery; however, incidental lesions of endometriosis were discovered during C-section that may cause severe adhesion. 5 …”

“…Signs of peritonitis may not allow performing primary repair and diversion with colostomy procedures highly recommended. 5 , 12 Some factors such as the complexity of the operative phase, use of electrosurgical energy, surgeon’s experience, the presence of adhesions between the rectum and uterus, omitted observation of the gastrointestinal contents, and absence of typical symptoms of bowel injury may contribute to increasing the risk for bowel injuries misdiagnosis and subsequently increases the rates of morbidity and mortality. 5 , 12 We recommended careful abdominal examination, gentle dissection of the tissues, and high suspicion of high-risk patients with previous abdominal operations.…”