A rare case of acute small bowel obstruction in immediate postpartum period: laparoscopic management

Abstract

Background: Intestinal obstruction due to right paraduodenal hernia in early postpartum period is rare. There is only one published case report on left-sided paraduodenal hernia (PDH) in early postpartum period, which was treated by open surgery [1]. However, we would like to present first ever case of right-sided PDH causing acute small bowel obstruction in early postpartum period, which was treated laparoscopically. Case Presentation: Our patient was a 29-year-old female who had undergone full-term normal delivery 4 days prior. She presented with acute small bowel obstruction to the emergency ward. Right PDH was diagnosed on contrast-enhanced abdominal computed tomography. She underwent laparoscopic repair. Right PDH is a congenital condition caused by incomplete rotation of the midgut in early embryological developmental phase. In our patient, increased intra-abdominal pressure during gestation probably forced more and more bowel loops to enter and get entrapped into the pre-existing defect. Conclusion: Right PDH is a rare entity and can rarely cause acute intestinal obstruction in immediate postpartum period.