Toxic colitis in a 10 year old girl with Crohn's disease

Toxic colitis is a well-described, life-threatening complication of inflammatory bowel disease (IBD). The vast majority of reported cases have been in adults. Limited literature exists describing toxic colitis in children with IBD. Virtually all reported pediatric cases have been in the setting of ulcerative colitis. We present a case of a 10 year old girl with Crohn's disease who was hospitalized because of advanced perianal disease with multiple abscesses and fistulae. During her stay, she developed acute toxic colitis with perforation requiring emergent colectomy. It is essential that clinicians are aware that this catastrophic complication can occur rapidly in the pediatric IBD population to ensure timely and appropriate management.