Bowel Obstruction Post-Fistula Retroureteral hernias are uncommon postoperative complications that can arise after surgical interventions. We present a case involving a 35-year-old woman who experienced a bladder and ureteral injury following an emergency cesarean section, leading to the formation of a vesicovaginal fistula. After undergoing fistula repair and ureteral reimplantation, she developed a bowel obstruction nearly two years later due to a retro ureteral hernia. A diagnostic laparoscopy revealed that the ureter had become intraperitoneal, causing the bowel to become entrapped. The surgical team successfully reduced the herniated bowel, retroperitonealized the ureter, and restored normal anatomy, resulting in the complete resolution of the patient’s symptoms and
Bowel obstruction
Bowel obstruction is a rare but serious complication that can occur following surgical repair of complex fistulas. This condition arises when the normal passage of intestinal contents is blocked, either mechanically or functionally, due to adhesions, scar tissue formation, or inflammation resulting from the surgical intervention. It poses significant challenges to both diagnosis and management, requiring prompt attention to prevent further complications such as bowel ischemia or perforation.
presentation
The presentation of bowel obstruction after fistula repair often includes symptoms such as abdominal pain, bloating, nausea, vomiting, and inability to pass stool or gas. Imaging studies, particularly abdominal X-rays, CT scans, or ultrasound, play a crucial role in identifying the location and severity of the obstruction. A thorough clinical assessment is also essential to distinguish between partial and complete obstructions, as treatment strategies may differ.
Management of bowel obstruction
Management of bowel obstruction following fistula repair depends on its severity. Mild cases may resolve with conservative measures such as bowel rest, nasogastric decompression, and intravenous fluid administration. However, severe or complete obstructions often necessitate surgical intervention to remove the blockage and restore intestinal function. In cases where bowel damage is detected, resection of the affected segment may be required.
Preventing bowel obstruction in the postoperative period involves meticulous surgical technique, proper handling of tissues, and minimizing adhesion formation.
literature review
This case study and literature review aim to provide a comprehensive overview of bowel obstruction as a postoperative complication of fistula repair. By understanding its etiology, clinical presentation, and management options, healthcare providers can improve patient outcomes and minimize the risk of this potentially life-threatening condition.
