Spontaneous Postpartum Cecal Perforation After Vaginal Delivery: An Unexpected Life-Threatening Complication of Ogilvie's Syndrome.

Acute colonic pseudo-obstruction (Ogilvie syndrome) is one of the rare but potentially fatal post-partum complications characterized by massive colonic dilation without mechanical obstruction. Cecal perforation secondary to Ogilvie syndrome is rarer and is associated with high morbidity and mortality. While more common after cesarean sections, its occurrence following vaginal delivery is extremely rare, and there are only a couple of case reports in the medical literature. Lack of awareness of these life-threatening post-partum complications among treating physicians can lead to unacceptable diagnostic delays, high morbidity, and mortality. Here, we report one such case of post-partum Ogilvie syndrome after vaginal delivery, which progressed to cecal perforation requiring explorative laparotomy, right hemicolectomy, and ileostomy. We intend to highlight the importance of these life-threatening complications, for which enhanced awareness, a high degree of suspicion with anticipation, and early diagnosis can help prevent progression to further complications. Prompt surgical intervention offers a better clinical outcome in these patients with cecal perforation.