Complicated Course of a Crohn’s Disease Case, Presenting with Abdominal Pain and Diagnosed with Ileal Fistula and Abscess

About one fifth of cases with Crohn’s disease (CD) are diagnosed in people less than 18 years. Although most of pediatric patients present with inflammatory behaviour, penetrating CD is increasingly seen. We report a case of an adolescent female, whose main complain was abdominal pain and who was diagnosed with ileal fistula and abscess. Even if surgery was initially planned, she has been treated with steroids and Sulphasalazine. She developed peritonitis and underwent ileo-cecal resection. Shortly after, an ileal fistula developed, requiring the second surgery. After the operation, she was given Sulphasalazine. In our service, she was found with active disease in the remnant ileum. She was switched to Mesalazine and Azathioprine. Currently, 13 months after starting the new therapy, she is in clinical and endoscopic remission. We emphasize the current concepts in managing fistulizing disease and preventing the postsurgical recurrence.