Gangrenous Cecal Volvulus Complicating Puerperium: Is the De
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Intestinal obstruction is a very rare event during pregnancy with reported incidence varying widely between 1 in 1500 to 1 in 66431. The most common cause of intestinal obstruction during pregnancy and puerperium is postsurgical adhesions (60–70%) followed by volvulus, which is seen in 25% of cases. Due to a host of reasons peculiar to pregnancy and puerperium diagnosis is often delayed and thus a simple mechanical obstruction of viable gut can become a serious case of volvulus with gangrene and life-threatening complications. We report a case of cecal volvulus during puerperium with delayed diagnosis leading to bowel gangrene to highlight the consequences and to ask a valid question: is the delay in diagnosis during pregnancy and puerperium really inevitable?

Case Report
A 26-year-old para two was referred to our hospital on third postpartum day with history of sudden onset lower abdominal cramping pain, abdominal distension, vomiting, and obstipation for two days. The patient had a spontaneous term uncomplicated vaginal delivery at home. The patient was earlier managed at a peripheral health institute conservatively and was referred to our hospital when her condition deteriorated. Her previous delivery was home conducted as well. There was no history of abdominal surgery in the past. Examination revealed moderate pallor and tachycardia. Abdomen was grossly distended and tender. Bowel sounds were absent. Routine investigations revealed hemoglobin of 6.4?gm% and an elevated leucocytic count of 16,000 per?cubic?mm.....