Postoperative Ileal Perforation after a Cesarean Section: A New Presentation of Crohn’s Disease
Abstract
Post-surgery ileus is a common complication after abdominal surgery. In cases of prolonged postoperative ileus lasting more than three days, underlying inflammatory bowel disease (IBD) should be considered. We present a 35-year-old woman who developed prolonged ileus after cesarean section, complicated by multiple ileal
perforations that led to the diagnosis of Crohn’s disease. This case illustrates smallbowel perforation as the first clinical presentation of Crohn’s disease in the postpartum period.
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[6] Pozios I, Seeliger H, Lauscher JC, Stroux A, Weixler B, Kamphues C, et al. Risk factors for upper and lower type prolonged postoperative ileus following surgery for Crohn’s disease. Int J Colorectal Dis. 2021;36(10):2165-2175. https://doi.org/10.1007/s00384-021-03969-9
[7] Stewart D, Waxman K. Management of postoperative ileus. Am J Ther. 2007;14(6):561-566. https://doi.org/10.1097/
MJT.0b013e31804bdf54
[8] Norton-Old KJ, Yuen N, Umstad MP. An obstetric perspective on functional bowel obstruction after cesarean section: A case series. J Clin Gynecol Obstet. 2016;5(1):53-57. https://doi.org/10.14740/jcgo389w
[9] Salehgargari S, Sahebdel B, Zare A, Abolhassani H. Ectopic decidual reaction mimicking irritable bowel syndrome: a case report. Acta Med Iran. 2014;52(1):88-90.
[10] Köklü S, Koçak E, Erel S, Dinç S. Crohn’s disease presenting with multiple intestinal perforation. J Crohns Colitis. 2010;4(2):217-218. https://doi.org/10.1016/j.crohns.2009.11.002
[11] Lee JH, Tey TT, Foo FJ, Koh F. Perforated viscus as first presentation of Crohn’s disease: a case report. J Surg Case Rep. 2021;2021(9):rjab415. https://doi.org/10.1093/jscr/rjab415
[12] Tadesse R, Ewnte B. Perforated ileum as the initial presentation of Crohn’s disease, a case report. Int J Surg Case Rep. 2022;97:107305. https://doi.org/10.1016/j.ijscr.2022.107305
[13] Haddad A, Mahmoud AB, Chaker Y, Zehani A, Ksantini R, Kacem MJ. Presentation with perforation of the terminal ileum and acute limb ischemia in Crohn’s disease: A case report. Int J Surg Case Rep. 2021;80:105626. https://doi.org/10.1016/j.ijscr.2021.01.097
[14] Adar T, Grisaru-Granovsky S, Ben Ya’acov A, Goldin E, BarGil Shitrit A. Pregnancy and the immune system: general
overview and the gastroenterological perspective. Dig Dis Sci. 2015;60(9):2581-2589. https://doi.org/10.1007/s10620-015-3683-z
[2] Venara A, Neunlist M, Slim K, Barbieux J, Colas PA, Hamy A, et al. Postoperative ileus: pathophysiology, incidence,
and prevention. J Visc Surg. 2016;153(6):439-446. https://doi.org/10.1016/j.jviscsurg.2016.08.004
[3] Zlakishvili B, Sela HY, Tankel J, Ioscovich A, Rotem R, GrisaruGranovsky S, et al. Post-cesarean ileus: An assessment of
incidence, risk factors and outcomes. Eur J Obstet Gynecol Reprod Biol. 2022;269:55-61. https://doi.org/10.1016/j.
ejogrb.2021.12.016
[4] Alhashemi M, Fiore JF, Safa N, Al Mahroos M, Mata J, Pecorelli N, et al. Incidence and predictors of prolonged postoperative ileus after colorectal surgery in the context of an enhanced recovery pathway. Surg Endosc. 2019;33(7):2313-2322. https://doi.org/10.1007/s00464-018-6514-4
[5] Abadi F, Shahabinejad M, Abadi F, Kazemi M. Effect of acupressure on symptoms of postoperative ileus after cesarean section. J Acupunct Meridian Stud. 2017;10(2):114-119. https://doi.org/10.1016/j.jams.2016.12.002
[6] Pozios I, Seeliger H, Lauscher JC, Stroux A, Weixler B, Kamphues C, et al. Risk factors for upper and lower type prolonged postoperative ileus following surgery for Crohn’s disease. Int J Colorectal Dis. 2021;36(10):2165-2175. https://doi.org/10.1007/s00384-021-03969-9
[7] Stewart D, Waxman K. Management of postoperative ileus. Am J Ther. 2007;14(6):561-566. https://doi.org/10.1097/
MJT.0b013e31804bdf54
[8] Norton-Old KJ, Yuen N, Umstad MP. An obstetric perspective on functional bowel obstruction after cesarean section: A case series. J Clin Gynecol Obstet. 2016;5(1):53-57. https://doi.org/10.14740/jcgo389w
[9] Salehgargari S, Sahebdel B, Zare A, Abolhassani H. Ectopic decidual reaction mimicking irritable bowel syndrome: a case report. Acta Med Iran. 2014;52(1):88-90.
[10] Köklü S, Koçak E, Erel S, Dinç S. Crohn’s disease presenting with multiple intestinal perforation. J Crohns Colitis. 2010;4(2):217-218. https://doi.org/10.1016/j.crohns.2009.11.002
[11] Lee JH, Tey TT, Foo FJ, Koh F. Perforated viscus as first presentation of Crohn’s disease: a case report. J Surg Case Rep. 2021;2021(9):rjab415. https://doi.org/10.1093/jscr/rjab415
[12] Tadesse R, Ewnte B. Perforated ileum as the initial presentation of Crohn’s disease, a case report. Int J Surg Case Rep. 2022;97:107305. https://doi.org/10.1016/j.ijscr.2022.107305
[13] Haddad A, Mahmoud AB, Chaker Y, Zehani A, Ksantini R, Kacem MJ. Presentation with perforation of the terminal ileum and acute limb ischemia in Crohn’s disease: A case report. Int J Surg Case Rep. 2021;80:105626. https://doi.org/10.1016/j.ijscr.2021.01.097
[14] Adar T, Grisaru-Granovsky S, Ben Ya’acov A, Goldin E, BarGil Shitrit A. Pregnancy and the immune system: general
overview and the gastroenterological perspective. Dig Dis Sci. 2015;60(9):2581-2589. https://doi.org/10.1007/s10620-015-3683-z
| Files | ||
| Issue | Vol 11 No 2 (2026): March-April | |
| Section | Case Report(s) | |
| Keywords | ||
| Postoperative ileus Bowel perforation Crohn’s disease Cesarean section | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Sahebdel B, Rashidi E, Raji H, Golshahi F, Aqavil-Jahromi S. Postoperative Ileal Perforation after a Cesarean Section: A New Presentation of Crohn’s Disease. CRCP. 2026;11(2):86-90.
