Multidetector Computed Tomography Evaluation of Uncommon Acute Post-Caesarean Section Complications
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Multidetector Computed Tomography (MDCT)
Caesarean Section
Uterine Rupture

How to Cite

Dar, M. A., Rafiq, S., Posh, S., & Wagay, I. (2021). Multidetector Computed Tomography Evaluation of Uncommon Acute Post-Caesarean Section Complications. Galician Medical Journal, 28(2), E202127.


Introduction. The most common major abdominal surgery in women is caesarean section. Despite being a safe procedure, a variety of complications, both acute and chronic, can occur. About 14.5% of caesarean sections result in complications. Infection followed by postpartum haemorrhage is the most frequent complication. Imaging modalities such as ultrasonography and multidetector computed tomography are often used in the evaluation of suspected uncommon post-caesarean complications. Computed tomography has been found to be a good initial modality for assessing acute postoperative complications after caesarean delivery.

The objective of the research was to evaluate the imaging findings and the characteristic visual manifestations of atypical acute complications of caesarean section, other than common complications such as postpartum haemorrhage, wound infection, etc.

Materials and Methods. This prospective study was carried out at the Department of Radiodiagnosis and Imaging, Government Medical College, Srinagar from June 2019 to February 2020 in collaboration with the Department of General Surgery and Gynaecology and Obstetrics of the Sher-i-Kashmir Institute of Medical Sciences. All patients with suspected complication in the immediate post-caesarean period were evaluated with contrast-enhanced multidetector computed tomography.

Results. Out of 427 patients who underwent caesarean section, 25 patients were suspected of having uncommon acute complications. Out of 25 patients evaluated for suspected immediate post-caesarean complication, only 5 patients had bladder flap hematoma, 8 patients were diagnosed with uterine dehiscence, 6 patients had uterine rupture, 3 patients suffered from ureteral injury, 1 patient had gossypiboma, 2 patients developed pelvic sepsis.

Conclusions. Multidetector computed tomography plays an important role in detection and confirmation of multiple acute complications after caesarean delivery and can also help in guiding the management of complications as well.
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Betrán AP, Merialdi M, Lauer JA, Bing-Shun W, Thomas J, Van Look P, et al. Rates of caesarean section: analysis of global, regional and national estimates. Paediatric and Perinatal Epidemiology [Internet]. 2007;21(2):98–113. Available from:

Dresang LT, Leeman L. Cesarean delivery. Primary Care: Clinics in Office Practice [Internet]. 2012;39(1):145–165. Available from:

Rebelo F, da Rocha CMM, Cortes TR, Dutra CL, Kac G. High cesarean prevalence in a national population-based study in Brazil: the role of private practice. Acta Obstetricia et Gynecologica Scandinavica [Internet]. 2010;89(7):903–908. Available from:

Rodgers SK, Kirby CL, Smith RJ, Horrow MM. Imaging after cesarean delivery: acute and chronic complications. RadioGraphics [Internet]. 2012;32(6):1693–1712. Available from:

Gonzalo-Carballes M, Ríos-Vives MÁ, Fierro EC, Azogue XG, Herrero SG, Rodríguez AE, et al. A pictorial review of postpartum complications. RadioGraphics [Internet]. 2020;40(7):2117–2141. Available from:

Gui B, Danza FM, Valentini AL, Laino ME, Caruso A, Carducci B, et al. Multidetector CT appearance of the pelvis after cesarean delivery: normal and abnormal acute findings. Diagnostic and Interventional Radiology [Internet]. 2016;22(6):534–541. Available from:

Deng M-F, Zhang X-D, Zhang Q-F, Liu J. Uterine rupture in patients with a history of multiple curettages: two case reports. World Journal of Clinical Cases [Internet]. 2020;8(24):6322–6329. Available from:

Twickler DM, Setiawan AT, Harrell RS, Brown CE. CT appearance of the pelvis after cesarean section. American Journal of Roentgenology [Internet]. 1991;156(3):523–526. Available from:

Hiller N, Schor-Bardach R, Gileles-Hillel A, Stroumsa D, Simanovsky N. CT appearance of the pelvis after Cesarean delivery—what is considered normal? Clinical Imaging [Internet]. 2013;37(3):514–519. Available from:

Kamaya A, Ro K, Benedetti NJ, Chang PL, Desser TS. Imaging and diagnosis of postpartum complications. Ultrasound Quarterly [Internet]. 2009;25(3):151–162. Available from:

Sierra A, Burrel M, Sebastia C, Radosevic A, Barrufet M, Albela S, et al. Utility of multidetector CT in severe postpartum hemorrhage. RadioGraphics [Internet]. 2012;32(5):1463–1481. Available from:

Tonolini M. Multidetector CT of expected findings and complications after hysterectomy. Insights into Imaging [Internet]. 2018;9(3):369–383. Available from:

Hofmeyr JG, Novikova N, Mathai M, Shah A. Techniques for cesarean section. American Journal of Obstetrics and Gynecology [Internet]. 2009;201(5):431–444. Available from:

Bates GW, Shomento S. Adhesion prevention in patients with multiple cesarean deliveries. American Journal of Obstetrics and Gynecology [Internet]. 2011;205(6):S19–S24. Available from:

DiFlorio-Alexander R, Harris RD. Postpartum complications. In: Fielding JR, Brown DL, Thurmond AS, editors. Gynecologic Imaging. Philadelphia, Pa: Elsevier; c2011. 381-398. Available from:

Bogot NR, Rottenstreich M, Nabulsi RM, Turner Y, Farkash R, Samueloff A, et al. The radiological myometrial appearance after cesarean section: is it associated with postpartum complications and subsequent delivery outcome? Abdominal Radiology [Internet]. 2017;43(8):2150–2155. Available from:

Rajasekar D, Hall M. Urinary tract injuries during obstetric intervention. BJOG: An International Journal of Obstetrics and Gynaecology [Internet]. 1997;104(6):731–734. Available from:

Mann WJ, Arato M, Patsner B, Stone ML. Ureteral injuries in an obstetrics and gynaecology training program: etiology and management. Obstet Gynecol. 1988;72(1):82-85.

Gavrić Lovrec V, Cokan A, Lukman L, Arko D, Takač I. Retained surgical needle and gauze after cesarean section and adnexectomy: a case report and literature review. Journal of International Medical Research [Internet]. 2018;46(11):4775–4780. Available from:

Jain M, Jain R, Sawhney S. Gossypiboma: ultrasound-guided removal. Journal of Clinical Ultrasound [Internet]. 1995;23(5):321–323. Available from:

Rasoaherinomenjanahary F, Ratsimarisolo N, Ramamonjiharisoa AG, Rakotondrainibe A, Ranoharison DH, Andriantsoa MJ, et al. Abdominal textiloma mimicking as left colic tumour: a postoperative complication still common in low-income countries. EMJ Radiology [Internet]. 2020;1(1):72-78. Available from:

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