From the delivery room to the operating room: A series of cascading complications from post-partum amoebic colitis causing intestinal perforation to anastomotic complication in a malrotated bowel

Amoebic colitis is an uncommon cause of acute abdomen in the postpartum period. We report a rare case of a 21-year-old female who presented with acute abdomen two days after normal vaginal delivery. Emergency exploratory laparotomy revealed intestinal malrotation with the cecum abnormally positioned at the splenic flexure, which was gangrenous and perforated. Histopathological examination confirmed amoebic colitis as the underlying etiology. Four months after the initial surgery, the patient developed intestinal obstruction leading to the anastomotic site becoming perforated requiring reoperation. This case represents an unusual combination of congenital intestinal malrotation and infectious colitis leading to acute abdomen, followed by significant postoperative complications. This report highlights the importance of considering both anatomical variations and parasitic infections in the differential diagnosis of acute abdomen, and the challenges in managing complications in the setting of previous infection and anatomical anomalies.