Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 11 2 2026 08 29 86 90 Behrokh Sahebdel Department of Obstetrics and Gynecology, Maternal Fetal and Neonatal Research Center, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Elham Rashidi Department of Obstetrics and Gynecology, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran. Hojatollah Raji Department of Pediatric Surgery, Children’s Medical Center (Pediatric Center of Excellence), Tehran University of Medical Sciences, Tehran, Iran. Fatemeh Golshahi Department of Obstetrics and Gynecology, Maternal Fetal and Neonatal Research Center, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Saeed Aqavil-Jahromi Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Tehran University of Medical Sciences, Tehran, Iran. 2026 06 27 2026 06 29 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. https://crcp.tums.ac.ir/index.php/crcp/article/view/1212 https://crcp.tums.ac.ir/index.php/crcp/article/download/1212/785