Inflammatory bowel diseases

Abstract

Introduction:Inflammatory bowel disease is a chronic condition of the gastrointestinal tract, comprising mainly Crohn disease (CD) and ulcerative colitis (UC). Both of them are frequently encountered in children, being multifactorial conditions, with an unclear etiology.Patients concerns:We present 4 cases of inflammatory bowel disease (IBD) in children in order to underline the variable evolution depending on the patient's particularities.Diagnosis, interventions and outcomes:The first case, a 13-year-old male patient, with a history of Henoch–Schonlein purpura, was admitted for rectal bleeding and weight loss, with normal laboratory parameters. The colonoscopy and the histopathological examination established the diagnosis of UC. The evolution was initially favorable under corticosteroids and sulfasalazine, but with 3 relapses in 2 years. The second case, a 16-year-old male patient, with a history of lactose intolerance and constipation, was admitted for bloody, diarrheic stools, the laboratory tests pointing out only leukocytosis with neutrophilia. The colonoscopy and histopathological examination established the diagnosis of UC. The patient's evolution was slowly favorable. The third case, a 9-year old male patient, with emotional disorders and babbling, admitted for semiconsistent, bloody stools, with increased inflammatory tests, whose colonoscopy pointed out diffuse edema and hemorrhages, the histopathological examination establishing the diagnosis of CD. The evolution was initially favorable, but with 5 relapses in 3 years. The last case, a 12-year-old male patient, was admitted with diarrheic, bloody stools, refractory to antibiotics, and weight loss, with increased inflammatory tests. The colonoscopy pointed out ulcerations, hemorrhages, and disseminated puss deposits. The histopathological examination established the diagnosis of CD. The patient's evolution was favorable, with only 1 relapse in 3 years.Conclusions:The adequate management, especially the self-management can influence the prognosis of patients with IBD, even though it is unpredictable and burdened by the risk of malignant transformation.

Pediatric ovarian tumors, a challenge for pediatrician and gynecologist

“…The imagistic tools are extremely useful in establishing the diagnosis of ovarian tumors and they usually consist in pelvic and abdominal ultrasound. [6] Ultrasound is widely used in the assessment of multiple pediatric pathologies, such as abdominal tumors, [9] inflammatory bowel diseases [10,11] (IBD-urile si SCAD-ul), but also cardiac malformations. [12] In certain cases, abdominal-pelvic MRI may also be required.…”

The peculiarities of Kawasaki disease at the extremes of age

“…Extremes of age represents an important risk factor for the development of CAAs associated to KD along with male gender, prolonged fever and a delay in diagnosis or treatment. [7] Thus, most often KD is misdiagnosed as infectious pathology, autoimmune disorders, [9,10] malignancies, [11,12] or even sepsis. [13] Echocardiography is therefore essential in diagnosing different cardiopathies.…”

Atypical onset of total colonic Hirschsprung disease in a small female infant

“…[ 11 ] Toxic megacolon is defined by total or segmental colonic dilation along with systemic toxicity, [ 26 ] and it can appear also associated with inflammatory bowel diseases. [ 27 ] This severe condition can be the first manifestation in previously undiagnosed HD patients, and it usually caries high mortality rates. [ 26 ] Our patients also presented initial signs of toxic megacolon, such as fever, severely dilated colon, leukocytosis, and elevated inflammatory biomarkers, but fortunately the surgical intervention was performed soon enough in order to avoid a fatal outcome.…”