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A Postoperative Complication Causing Physician Consternation

From the ¹Oregon Health and Sciences University, Portland, Oregon.

These cases were presented at the "Stump the Professors" session at the Annual Clinical Meeting of the American College of Obstetricians and Gynecologists, May 8, 2007. The outcome of each case appears starting on p. 1460 and a video of the session can be viewed at www.greenjournal.org.

BACKGROUND: Postoperative ileus and urinary retention are relatively common complications after obstetric and gynecologic procedures. This case highlights an unusual cause of these common postoperative patient reports.

CASE: A 71-year-old woman underwent an uncomplicated total vaginal hysterectomy and pelvic reconstruction for stage III pelvic organ prolapse. She subsequently presented with and was hospitalized for labile blood pressures, ileus, urinary retention, and subjective sensory and motor complaints. The cause of the patient’s reports was not clear until her disease became relatively severe.

CONCLUSION: When a postoperative patient has multiple symptoms that do not respond to standard intervention, rare causes outside of one’s specialty should be considered.