Paediatric gastric and intestinal Crohn's disease detected by (18)F-FDG PET/CT

Area of Science:

• Gastroenterology
• Pediatric Inflammatory Bowel Disease
• Medical Imaging

Background:

• Crohn's disease is a chronic inflammatory bowel disease that can affect any part of the gastrointestinal tract.
• Gastric involvement in Crohn's disease is rare, particularly in pediatric cases.
• Extra-intestinal manifestations are common in Crohn's disease and can include fever and skin conditions.

Observation:

• A 12-year-old boy presented with fever and lower limb rash, leading to an investigation for fever of unknown origin.
• Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) was utilized for diagnostic evaluation.
• Gastroscopy revealed polypoid hyperplasia and ulcers in the stomach, with pathology suggesting gastric Crohn's disease.

Findings:

• The patient was diagnosed with both gastric and intestinal Crohn's disease.
• (18)F-FDG PET/CT imaging was instrumental in diagnosing the underlying cause of the prolonged fever.
• Histopathological examination confirmed Crohn's disease in both gastric and intestinal tissues.

Implications:

• This case highlights the importance of considering Crohn's disease, including gastric involvement, in pediatric patients with unexplained fever and extra-intestinal symptoms.
• Early and accurate diagnosis using advanced imaging techniques like (18)F-FDG PET/CT is crucial for effective management.
• The findings underscore the variable presentation of Crohn's disease and the need for comprehensive diagnostic approaches.