Predictors of surgical intervention in the onset of stenotic Crohn’s disease in a 15-year-old teenager

Abstract

Aim: to demonstrate a child with early ileocecal resection in stenosing Crohn’s disease, taking into account the risk factors of surgical intervention. Crohn’s disease (CD) is a chronic recurrent segmental granulomatous lesion of any part of the gastrointestinal tract, with a wide range of manifestations and various phenotypes of the disease. Despite the great diagnostic and therapeutic possibilities today, there is an increase in primary and secondary resistance to therapy, largely associated with an incorrect assessment of the CD phenotype, patient management strategy. In the above observation of CD in a teenager, clinical signs of ileocecal stenosis were observed 3 months after the supposed onset of the disease, which caused a planned laparoscopic ileocecal resection with the formation of a ileo-colon anastomosis. The start of CD in adolescence, positive ASCA-status are regarded as risk factors for surgical intervention in this child. Timely diagnosis did not allow to avoid surgery. It is necessary to make individual algorithms for the management of a child with CD, taking into account the predictors of surgical intervention, complications and unfavorable course of the disease already at the time of diagnosis.