# Management of unspecified abdominal pain and its complications: A case reports

## TL;DR

A case report describes the diagnosis and treatment of unspecified abdominal pain after a cesarean section, highlighting the importance of timely intervention to prevent complications.

## Contribution

This case report presents a rare complication of bladder rupture after cesarean section and emphasizes the effectiveness of FAST, laparotomy, and cystostomy in managing such cases.

## Key findings

- Bladder rupture was diagnosed as the cause of unspecified abdominal pain 13 days after cesarean section.
- FAST and KUB X-ray were effective diagnostic tools in unstable patient conditions.
- Laparotomy and cystostomy combined with antibiotics minimized mortality in this case.

## Abstract

Acute abdomen after section cesarean (SC) is a case that can occur, and the diagnosis of the cause is very challenging. This case report describes the immediate diagnostic and management of unspecified abdominal pain on Day 13th post-SC, accompanied by complications.

A 30-year-old woman with a history of SC on the 13th day came to the Emergency Room (ER) with abdominal pain and decreased consciousness. Focused Assisted Sonography in Trauma (FAST) and Kidney Ureter Bladder (KUB) X-ray as a diagnostic tool was performed, followed by laparotomy as definitive management. We found a 7 cm bladder rupture in the bladder dome, 8 L of urine mixed with pus, and 300 cc of blood clots. We manually evacuated the urine and blood clots and refreshed the bladder tissue and cystostomy, and then the bladder was sutured. Double antibiotics were given for Staphylococcus hemolyticus infection.

The diagnosis of abdominal pain was challenging. Late diagnosis can cause complications and mortality. FAST and KUB X-rays are useful tools in the care of bladder rupture after SC. Laparotomy is an option for treatment. In this case, the patient underwent laparotomy followed by cystostomy. The role of double antibiotics is necessary in cases of sepsis.

Patients with unspecified abdominal pain after SC need immediate diagnosis. Diagnosis with FAST is sufficient to be done in unstable patient conditions. Immediate management with Laparotomy and Cystostomy combined with antibiotics can minimize mortality.

•Unspecified abdominal pain caused by bladder rupture can occur as a complications after section cesarean.•Delay in recognizing and treating abdominal pain can lead to complications and mortality in patients.•FAST, laparotomy exploration, and comprehensive post-operative care are the treatments.•Cystostomy is used to reduce the workload of the bladder after bladder repair.

Unspecified abdominal pain caused by bladder rupture can occur as a complications after section cesarean.

Delay in recognizing and treating abdominal pain can lead to complications and mortality in patients.

FAST, laparotomy exploration, and comprehensive post-operative care are the treatments.

Cystostomy is used to reduce the workload of the bladder after bladder repair.