Nakaya Kengo, Iinuma Yasushi, Hirayama Yutaka, Sugai Yu, Taki Shotaro
Department of Pediatric Surgery, Niigata City General Hospital, Shumoku 463-7, Chuo-ku, Niigata 950-1197, Japan.
Case Rep Pediatr. 2020 Dec 9;2020:8832856. doi: 10.1155/2020/8832856. eCollection 2020.
Inflammatory bowel disease is rare in infants, and the early diagnosis is very important. We herein report an infant who received an early diagnosis of infantile Crohn's disease (CD). A two-month-old boy presented with bloody stool. He developed a poor sucking tendency and a painful perianal lesion at three months of age. He was suspected of having infantile CD because of his atypical perianal lesion. Colonoscopy revealed that his perianal lesion had induced rectal longitudinal ulcers. Histology showed no granulomas but patchy inflammation reaching the submucosal layer. He was diagnosed with infantile CD based on the Japanese criteria. CD should be suspected in infants with atypical perianal lesions, irrespective of their age. Early colonoscopy with histology should be considered in these cases in order to prevent adverse outcomes in children.
炎症性肠病在婴儿中较为罕见,早期诊断非常重要。我们在此报告一例早期诊断为婴儿克罗恩病(CD)的婴儿。一名两个月大的男婴出现便血。三个月大时,他出现吸吮无力和肛周疼痛性病变。由于其非典型的肛周病变,他被怀疑患有婴儿CD。结肠镜检查显示其肛周病变导致直肠纵行溃疡。组织学检查未发现肉芽肿,但有片状炎症累及黏膜下层。根据日本标准,他被诊断为婴儿CD。对于有非典型肛周病变的婴儿,无论其年龄大小,均应怀疑患有CD。对于这些病例,应考虑早期进行结肠镜检查及组织学检查,以防止儿童出现不良后果。