A patient was referred from periphery with abdominal distension,peritonism and shock

A patient was referred from periphery with abdominal distension,peritonism and shock.
She had c-section 4 days back and she stayed in ileus in post operative period.
We suspected iatrogenic small gut injury.
Upon exploration a blown out cecum was found because of prolonged ileus and excessive gut distension.
Moral: Dont take post op ileus light.
Manage actively and consider exploration +/- cecostomy when distension increases.