[Lower gastrointestinal bleeding secondary to Chronic Nonspecific Ulcerative Colitis: A clinical case]

Gastrointestinal bleeding (GIB) has a low incidence in pediatrics. It could be of the upper or lower track, the first one being the most common. Etiology varies according to the age group. Chronic nonspecific ulcerative colitis (UC) is heterogeneous in nature, with a varying severity among patients. The purpose of the present manuscript is to exhibit the unusual case in pediatrics of an adolescent with a lower tract GIB due to UC.

A 16-year-old female was brought to the pediatric emergency department for a lower tract GIB. Ten days prior receiving medical attention, she presented with hematochezia, Bristol 3 consistency, straining and a pattern of 5 times a day. She also presented with moderately intense abdominal pain located in the hypogastrium and mid-gastric region, cramp-like, non-irradiating, which partially resolved upon bowel movements. She also presented with fatigue, weakness, and weight loss of approximately 3 kg; no fever. She had no personal history of illness. A colonoscopy was performed, revealing friable, erythematous intestinal mucosa alongside layered bleeding and fibrin plaques in the descending, transverse, and ascending colon. Biopsies were taken from the entire colon and rectum. The diagnosis of UC was confirmed based on clinical, endoscopic, and anatomopathological criteria.

The present case shows how a previously healthy adolescent presented with UC manifested by lower tract GIB, abdominal pain, and wasting syndrome, a rare condition in the pediatric population.