Reza Fahlevi, Fatimah Safira Alatas, Ria Subekti
Objective: Inflammatory bowel disease (IBD) is sometimes challenging especially in poor facility setting. Proper diagnostic approach is needed for prompt management of IBD. This case report is aimed to present the case of IBD in children with diagnostic challenges. Case Illustration: A five years-old girl referred to tertiary national hospital with recurrent bloody diarrhea for two years before admission. She was previously diagnosed with dysentery and cow’s milk allergy from previous hospital and received recurrent packed red cell transfusion due to anemia. After undergone several examinations, she was diagnosed with inflammatory bowel disease (Crohn’s disease) based on the colonoscopy, esophagogastroduodenoscopy, and histopathological examination. However, late recognition of IBD was led to failure to thrive condition in this patient. Nevertheless, the patient has received definite treatment with intravenous methyl prednisolone and experienced remarkable clinical improvement. From this case, we understand that establishing diagnosis of IBD could be challenging, especially in poor facility setting. Late diagnostic establishment of IBD mostly due to lack of physician’s awareness and limited facilities. This would lead to some complications of IBD such as recurrent anemia and failure to thrive which were occurred in our patient. Conclusion: Increasing awareness of physicians and early diagnosis establishment are the essential aspects in managing IBD cases in pediatric population especially in poor facility setting.