Three Cases of Pediatric Crohn’s Disease Initially Presented as Perianal Lesions

Abstract

We report the cases of three male children diagnosed as having Crohn’s disease (CD) with perianal lesions as the initial complaint presented. The patients were 8, 11, and 10 years old and, prior to visiting our hospital, had received treatment for perianal lesions at other clinics for 2 years, 2 months, and 6 months, respectively, but with no improvement. Although they had no abdominal symptoms, endoscopic examinations were performed under general anesthesia with suspicion of CD because their blood tests showed anemia, leukocytosis, and elevated CRP levels. The endoscopic examinations revealed aphthous ulcers in their small and large intestines and hence were diagnosed as having small/large-intestine-type CD. Moreover, the weights of two of the patients showed a downward deviation in the growth chart. Perianal lesions may be manifested in CD patients prior to abdominal symptoms. When examining children with perianal lesions and/or poor weight–height gain, further investigation with endoscopy is necessary to check for the possibility of CD.