The patient underwent a difficult primary low segment C-section, during which the surgeon noted the uterus was scarred and sclerosed. On the first day after her surgery, the patient’s white blood cell count was noted to be 3.2 with a left shift. Her urinary output was low and she had periods of hypotension.
The next day, the patient had increasing abdominal pain and progressively lower blood pressure. Her abdomen was noted to be markedly distended but there was no focal tenderness. The patient then began breathing rapidly. The attending surgeon admitted the patient to the ICU for concern of systemic inflammatory response syndrome. An IV bolus was given and her lactate was elevated. A general surgeon was consulted and noted an acute abdomen. The patient went for an exploratory laparotomy which revealed a 3 cm hole in the distal ileum and 2 liters of fecal material in the patient’s peritoneal cavity. A portion of the bowel was resected and a primary anastomosis was performed. The patient was admitted to the ICU for several weeks and underwent 2 additional washouts and wound closures. The patient required intense rehabilitation to recover from her condition.