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Peer-reviewedCC BY-NC-ND 4.0The American Journal of Case Reports

Cesarean Delivery After Multiple Prior Intraperitoneal Surgeries: A Case Report in a Patient With Crohn Disease

  • Daniel Wolder1
  • Agata Michalska1
  • Jagoda Zakrzewska2
  • Jakub Kowalski2
  • Grzegorz Świercz1
  • Israel Hendler3,4
  • Luka Velemir5
5 affiliations
  1. 1Collegium Medicum, Jan Kochanowski University in Kielce, Kielce, Poland
  2. 2Clinic of Obstetrics and Gynecology, Provincial Combined Hospital in Kielce, Kielce, Poland
  3. 3Department of Obstetrics and Gynecology, Nazareth Hospital EMMS, Nazareth, Israel
  4. 4Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
  5. 5Gynecology Institute of Nice – French Riviera, Nice, France
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Abstract

Patient: Female, 25-year-old

Final Diagnosis: Pregnancy requiring cesarean delivery in a patient with multiple prior intraperitoneal surgeries

Symptoms: None – asymptomatic, uncomplicated pregnancy

Clinical Procedure: Extraperitoneal French Ambulatory Cesarean Section (FAUCS)

Specialty: Obstetrics and Gynecology

Objective: Rare coexistence of disease or pathology

Background: The mode of delivery in women with inflammatory bowel disease (IBD), including Crohn disease, requires individualized multidisciplinary assessment. Prior abdominal surgery increases the risk of intra-abdominal adhesions and operative complications. The extraperitoneal French Ambulatory Cesarean Section (FAUCS) technique may help avoid peritoneal entry in selected patients with complex surgical histories. This report describes the feasibility and short-term perioperative outcome of FAUCS in a patient with multiple prior intraperitoneal surgeries. Crohn disease is presented as a relevant comorbidity rather than the primary operative indication.

Case Report: We report the case of a 25-year-old woman with Crohn disease and a history of 5 prior intraperitoneal surgical procedures, including bilateral hemicolectomy, colostomy formation, appendectomy, and adhesiolysis. The pregnancy was achieved through in vitro fertilization and remained uncomplicated, with Crohn disease in sustained clinical remission. No preoperative imaging was performed; the likelihood of adhesions was inferred from multiple laparotomies and previous adhesiolysis. Due to anticipated extensive intra-abdominal adhesions, elective cesarean delivery using the extraperitoneal FAUCS technique was performed under an enhanced recovery after cesarean (ERAC) pathway. A healthy male neonate was delivered at 37 weeks of gestation, weighing 2550 g (Apgar score 10 at 5 minutes). Postoperative recovery was uncomplicated, with early oral intake, mobilization, minimal analgesic requirements, and no postoperative complications.

Conclusions: This case documents the feasibility and perioperative outcomes of extraperitoneal FAUCS in a rare scenario involving multiple prior intraperitoneal surgeries and Crohn disease in remission. It is intended to support clinician awareness and case-based learning rather than establish safety or efficacy claims.

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Cite

BibTeXRIS
BibTeX
@article{wolder2026cesarean,
  title = {{Cesarean Delivery After Multiple Prior Intraperitoneal Surgeries: A Case Report in a Patient With Crohn Disease}},
  author = {Daniel Wolder and Agata Michalska and Jagoda Zakrzewska and Jakub Kowalski and Grzegorz Świercz and Israel Hendler and Luka Velemir},
  journal = {The American Journal of Case Reports},
  year = {2026},
  month = nov,
  doi = {10.12659/ajcr.953591},
  url = {https://doi.org/10.12659/ajcr.953591},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Cesarean Delivery After Multiple Prior Intraperitoneal Surgeries: A Case Report in a Patient With Crohn Disease
AU  - Daniel Wolder
AU  - Agata Michalska
AU  - Jagoda Zakrzewska
AU  - Jakub Kowalski
AU  - Grzegorz Świercz
AU  - Israel Hendler
AU  - Luka Velemir
PY  - 2026
DA  - 2026/11/01
JO  - The American Journal of Case Reports
DO  - 10.12659/ajcr.953591
UR  - https://doi.org/10.12659/ajcr.953591
AB  - Patient: Female, 25-year-old  Final Diagnosis: Pregnancy requiring cesarean delivery in a patient with multiple prior intraperitoneal surgeries  Symptoms: None – asymptomatic, uncomplicated pregnancy  Clinical Procedure: Extraperitoneal French Ambulatory Cesarean Section (FAUCS)  Specialty: Obstetrics and Gynecology  Objective: Rare coexistence of disease or pathology  Background: The mode of delivery in women with inflammatory bowel disease (IBD), including Crohn disease, requires individualized multidisciplinary assessment. Prior abdominal surgery increases the risk of intra-abdominal adhesions and operative complications. The extraperitoneal French Ambulatory Cesarean Section (FAUCS) technique may help avoid peritoneal entry in selected patients with complex surgical histories. This report describes the feasibility and short-term perioperative outcome of FAUCS in a patient with multiple prior intraperitoneal surgeries. Crohn disease is presented as a relevant comorbidity rather than the primary operative indication.  Case Report: We report the case of a 25-year-old woman with Crohn disease and a history of 5 prior intraperitoneal surgical procedures, including bilateral hemicolectomy, colostomy formation, appendectomy, and adhesiolysis. The pregnancy was achieved through in vitro fertilization and remained uncomplicated, with Crohn disease in sustained clinical remission. No preoperative imaging was performed; the likelihood of adhesions was inferred from multiple laparotomies and previous adhesiolysis. Due to anticipated extensive intra-abdominal adhesions, elective cesarean delivery using the extraperitoneal FAUCS technique was performed under an enhanced recovery after cesarean (ERAC) pathway. A healthy male neonate was delivered at 37 weeks of gestation, weighing 2550 g (Apgar score 10 at 5 minutes). Postoperative recovery was uncomplicated, with early oral intake, mobilization, minimal analgesic requirements, and no postoperative complications.  Conclusions: This case documents the feasibility and perioperative outcomes of extraperitoneal FAUCS in a rare scenario involving multiple prior intraperitoneal surgeries and Crohn disease in remission. It is intended to support clinician awareness and case-based learning rather than establish safety or efficacy claims.
SN  - 1941-5923
ER  -