Conclusions

This single case suggests that ISMAD should be considered in postpartum patients with sudden, atypical, severe, or disproportionate abdominal pain, even when postoperative bleeding appears plausible. Contrast-enhanced CT is essential for identifying visceral arterial dissection, evaluating distal perfusion and bowel ischemia, and guiding management. Although this case does not establish a causal relationship between cesarean delivery and ISMAD, conservative treatment may be appropriate in carefully selected, hemodynamically stable patients without bowel ischemia, arterial rupture, or progressive symptoms. Further reports are needed to clarify the underlying mechanisms and optimal management of postpartum ISMAD.