An unusual case of postoperative ascites after cesarean section

Namrita Sandhu, Sanjay Singh


Post-operative ascites following caesarean section is rarely reported in pregnancy. Ascites has multiple etiologies including malignancies, liver cirrhosis, intraperitoneal infections and trauma. Authors report a case of post-operative ascites following caesarean section performed at around 37 weeks of gestation. The patient was normotensive. The diagnosis and treatment of ascites as well as the pregnancy outcome is presented. Literature review of ascites in pregnancy is discussed as well. This case was that of an idiopathic ascites with no definitive cause. An allergic or inflammatory peritoneal reaction may be the most likely cause for this complication.


Ascites, Inflammatory peritoneal reaction, Post cesarean

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Jiang W, Cong Q, Wang YS, Cao BR, Xu CJ. Postoperative ascites of unknown origin after laparoscopic gynecologic surgery: a 5-year experience of 8 cases and review of the literature. Surg Laparosc Endosc Percutan Tech. 2012;22(3):e129-e131.

Thompson KA, Al Khabbaz A. Incidental chylous ascites at the time of cesarean section. Obstet Gynecol. 2015;2015:530210.

Cardenas A, Chopra S. Chylous ascites. Am J Gastroenterol. 2002;97(8):1896-900.

Almakdisi T, Massoud S, Makdisi G. Lymphomas and chylous ascites: review of the literature. The Oncol. 2005;10(8):632-5.

Habek D, Habek JC, Vujic B. Nontraumatic chyloperitoneum in pregnancy. Eu J Obstet Gynecol Reprod Biol. 2005;122(2):245-7.

Vaijyanath AM, Nayar B, Malhotra N, Deka D. Massive ascites in severe pre-eclampsia: a rare complication. J Obstet Gynaecol Res. 2002;28(4):199-202.

Chawla S, Kumar BP, Bhalla M. Case of ascites in pre- eclampsia. Med J Arm Forces India. 2012;68(3):257-9.

Brown MA, Zammit VC, Lowe SA. Capillary per- meability and extracellular fluid volumes in pregnancy induced hypertension. Clin Sci. 1989;77(6):599-604.

Feretis M, Boyd-Carson H, Karim A. Postoperative ascites of unknown origin following laparoscopic appendicectomy: An unusual complication of laparoscopic surgery. Case Rep Surg. 2014;2014:549791.

Milingos S, Protopapas A, Chatzipapas I, El Sheikh A, Liapi A, Michalas S. Postoperative ascites developing after laparoscopic surgery can become a difficult diagnostic dilemma. J Am Assoc Gynecol Laparoscop. 2001;8:587-90.

Zhao X, Wang M, Huang X, Yu H, Wang X. Idiopathic postoperative ascites after laparoscopic salpingectomy for ectopic pregnancy. J Minimal Inv Gynecol. 2005;12:439-41.

Rabiei M, Darvish S, Ghozat R. An unusual case of post-operative ascites after cesarean section delivery. Case Rep Clin Pract. 2016;1(3):68-70.

Gado A, Badawi H, Karim A. An unusual case of peritonitis following a caesarean delivery. Alexandria J Med. 2018;54(4):369-71.

Villota ED, Mosquera J, Rubio J. Association of a low serum albumin with infection and increased mortality in critically ill patients. Intens Care Med. 1980;7:19-22.