Paralytic ileus is a potential complication following cesarean section, though its delayed onset is uncommon and may present diagnostic challenges. We report a rare case of a 45-year-old woman who developed acute gastrointestinal paralysis 13 days after an uncomplicated elective cesarean section. The patient initially recovered well postoperatively, passing flatus within 24 hours and stool by the third day. However, nearly two weeks after discharge, she presented with abdominal distension, nausea, vomiting, fever, and an inability to pass flatus or stool. Laboratory tests revealed elevated inflammatory markers, and imaging showed gastrointestinal dilation without evidence of mechanical obstruction. Conservative management, including nasogastric decompression, intravenous fluids, and parenteral nutrition, led to a complete resolution without the need for surgical intervention. Although this condition typically occurs in the early postoperative period, its delayed presentation highlights the need for clinical awareness in postpartum patients with persistent gastrointestinal symptoms. Early recognition and appropriate management are essential for ensuring favorable patient outcomes.
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