A rare complication of uterine rupture following C-section: Intestinal obstruction due to internal hernia

Although post-operative acquired internal hernias at the cesarean (C) section incision site of the uterus were reported previously, there is no case in the literature in which intestinal herniation into uterine cavity at a different site than C-section uterine incision was reported. We report here for the first case in which bowel was herniated into uterine cavity from an un-incised location. A thirty-six year old woman was hospitalized with mechanical intestinal obstruction who had a C-section operation 2 weeks ago at 36th gestational week. During laparotomy about 20 cm of small bowel was found to be herniated into uterine cavity from a 3x2 cm defect, on the right of uterus isthmus. Because herniated bowel was perforated and necrotized, resection and anastomosis were performed. Uterine perforations mostly heal spontaneously without any complications. However, possibility of herniation into uterine cavity should be kept in mind when bowel obstruction symptoms are encountered after a C-section.