Errors in the diagnosis of inflammatory bowel disease in a 2-year-old child using the example of one clinical case.

Background. Inflammatory bowel disease (IBD) occurs in approximately 4-5 children per 100,000 and is more severe than in adults. IBD is predominantly diagnosed in boys aged 11–17 years, but data on the incidence of very early onset (before 6 years) remain contradictory. (Khavkin A.I., Naletov A.V., Marchenko N.A. Inflammatory bowel disease in children: current advances in diagnostics and therapy. Russian Journal of Gastroenterology, Hepatology, Proctology. 2023; 33 (6): 7-15. https://doi.org/10.22416/1382-4376-2023-33-6-7-15)
Description of a clinical case. a 2-year-10-month-old female patient complaining of blood in the stool underwent a colonoscopy only 3 months after the initial visit to the doctor and endoscopic and morphological signs of inflammatory bowel disease were detected; after conservative measures, the stool became semi-formed, no signs of bleeding were noted. The child was discharged in a satisfactory condition with recommendations to continue symptomatic therapy under the supervision of a district gastroenterologist and pediatrician. The gold standard for diagnosing IBD is an endoscopic examination with a colon biopsy. However, in young children, invasive methods are often avoided due to technical difficulties and risks and often parental refusal.
In this clinical case, the onset at 2 years of age could have been the reason for underestimating IBD as a possible diagnosis, as well as late endoscopy
Conclusion. If inflammatory bowel disease (IBD) is suspected, it is important to quickly and accurately diagnose this condition, since there is a high risk of the acute course turning into a chronic one with subsequent deterioration.