Abdominal pain post cesarean section

A 26 y/o female, G3P returned on postoperative day 4 complaining of 2 days of nausea, bilious emesis, and abdominal pain. Physical exam and acute abdominal series were suggestive of a postoperative ileus versus small bowel obstruction. Pateint has history of a previous laparoscopic cholecystectomy underwent emergency cesarean section at term for non-reassuring fetal status. Operative findings at that time revealed a normal uterus, fallopian tubes, broad ligaments, and ovaries. What is the cause of her abdominal discomfort?

- Actue intestinal obstruction - RT aspiration - NBM - IV fluids, antibiotics - I/O chart
First look for bowel sounds...if absent then we have to think of paralytic ileus...and manage according and if present they they go for intestinal obstruction side though it is less likely...you can assess by amt of RT drainage also...also go for serum lipase and amylase too as I have seen few cases of subacute pancreatitis go into full blown flare after delivery...also take a surgeon's opinion too....it may be a simple cases of feeding intolerance also...but it should subside in 48 hrs with minimal measures...
Early feeding intolerance to oral intake may cause and discomfort Keep her nil orally IV Fluids antacid laxatives may relieve her
Xray abdomen in standing to be done. Rule out intestinal obstruction also. Treatment as per reports
Feeding intolerence.. Restrict the frequencies of feedi g. Gastic flutence to be taken care of.

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