Terminal ileal endometriosis masquerading as Crohn’s disease: a rare cause of small bowel obstruction and perforation in a middle-aged woman

This case underscores the rare and deceptive presentation of ileal endometriosis mimicking Crohn's disease, culminating in small bowel obstruction and perforation in a patient without any prior history or gynecologic symptoms.What sets this case apart is the presence of both ileal and appendiceal endometriotic inclusions, in the absence of typical mucosal involvement or prior diagnosis of endometriosis.The diagnosis was only confirmed postoperatively through histopathology, reinforcing the importance of considering endometriosis in the differential diagnosis of terminal ileal lesions-even in patients beyond peak reproductive years and with no classic symptoms.