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Summary: We present a case report of a young female patient with complicated course of inflammatory bowel disease with severe luminal, as well as perianal symptoms. The patient was initially dia­gnosed with ulcerative colitis and underwent proctocolectomy with ileopouch-anal anastomosis. One year after oostomy closure she got pregnant and, at the same time, she developed perianal abscess and fistula. The dia­gnosis was thus changed to Crohn’s disease. During pregnancy, she underwent repeated perianal fistula drainages, surgical revision of ileus and treatment with ustekinumab was started. The patient delivered a healthy boy in November 2022 at 38th gestational week. Key words: Crohn’s disease – perianal Crohn’s disease – ustekinumab – pregnancy