iarjimphIARJIMPHIARJIMPH2709-331Xhttps://doi.org/10.47310/iarjimph.2021.v02i01.004Bowel Injury during Cesarean SectionSamaraMohammedMahdiWissamHusseinSabbryElafAiedShakerCaesarean section (CS) is a commonly performed surgical procedure for fetal delivery and may be planned antenatally or undertaken after the onset of labor when clinically indicated. Although generally safe, CS is associated with postoperative complications, one of which is postoperative ileus. Postoperative ileus affects the entire intestine, with recovery occurring at different rates: small intestinal function typically returns within 24 hours, gastric activity within 24–48 hours, and colonic peristalsis may be delayed for up to 72 hours after surgery. Acute colonic pseudo-obstruction, a rare form of postoperative ileus characterized by marked colonic dilatation without mechanical obstruction, has been infrequently reported following cesarean delivery in recent literature. Delayed diagnosis or inappropriate management may result in serious complications, including cecal ischemia or colonic perforation. This article reports four cases of postoperative ileus following cesarean section and provides a concise review of the relevant literature. Key clinical aspects are summarized, including proposed pathophysiological mechanisms, clinical presentation, diagnostic considerations, differential diagnosis, and management strategies. Emphasis is placed on early recognition and timely intervention to reduce morbidity, prevent severe complications, and shorten the duration and severity of the condition.