Bowel Perforation Associated With Infliximab Use in a Pediatrics Patient

Crohn's disease (CD) is an idiopathic inflammatory disease of the gastrointestinal tract and typically causes inflammation with granuloma formation. Biologic agents like infliximab (IFX) that target tumor necrosis factor alpha (TNF-α), have emerged as important medications for treating refractory CD. With increasing use, there also are reports of rare but potentially fatal complications associated with exposure to TNF-α, such as bowel perforation. We present a case report of spontaneous bowel perforation in a child with Crohn's while on IFX therapy, and a review of the current literature. The purpose of this report is to alert physicians to this rare association, especially in pediatric patients with intestinal strictures.