Crohn's Disease: Case Presented at the Regional Hospital Moquegua, Peru

Abstract

Introduction: Crohn's disease appears very rarely in pediatric age, although its incidence and prevalence worldwide have increased in recent years. Objective: To present the case of a nine-year-old patient with Crohn's disease, who attended the Pediatric Emergency Department of the Regional Hospital Moquegua, Peru. Presentation of the case: The patient presented with a history of bloody diarrheal stools, vomiting and abdominal pain in the last two years. Physical examination revealed pallor, dry oral mucosa, soft depressible abdomen, increased intensity and frequency of hydroaerial sounds, and pain on deep palpation in the epigastrium. Colonoscopy showed, in the sigmoid colon, mucosa with isolated erosions and loss of vascular tissue in areas; in the rectum, edematous mucosa with diffuse erythema and loss of vascular tissue with bleeding in a superficial map that could be easily washed out. A biopsy of fragments of the left and right colon, cecum and rectum was performed, which showed friability when taken, hyperplasia and distortion of crypts, inflammatory infiltrate of lymphoplasmacytic predominance and presence of some eosinophils and neutrophils in lamina propria, compatible with Crohn's disease. Treatment with methylprednisolone, prednisone and mesalazine was started. Consistency and bleeding in the dispositions improved noticeably. Conclusions: Crohn's disease should be suspected in pediatric patients with bloody diarrhea and abdominal pain of chronic relapsing course. Timely diagnosis and multidisciplinary treatment are important to avoid complications.