The Cobblestone Sign in a Child with Crohn’s Disease
In this case, terminal ileitis with a typical cobblestone-like relief pattern was seen at the time of diagnosis of Crohn’s disease (Figure). The patient, a 12-year-old girl, complained of having suffered from abdominal pain that had recently worsened, along with recurrent, sometimes bloody diarrhea, for the past five years. She dropped on her weight curve from the 75th to the 25th percentile. One year earlier, she had undergone a procedure for the treatment of a gluteal abscess. She also recalled having had mouth sores. Crohn‘s disease often manifests itself in a latent manner in childhood and adolescence, with uncharacteristic or heterogeneous signs and symptoms, even though its severity and course are worse overall than in adulthood.
Julia Ortwein, Dr. med. Jan de Laffolie, Prof. Dr. med. Klaus-Peter Zimmer, Zentrum für Kinderheilkunde und Jugendmedizin, Justus-Liebig-Universität Gießen, Julia.Ortwein@paediat.med.uni-giessen.de
Conflict of interest statement
The authors state that they have no conflict of interest.
Translated from the original German by Ethan Taub, M.D.
Cite this as:
Ortwein J, de Laffolie J, Zimmer K-P: The cobblestone sign in a child with Crohn’s disease. Dtsch Arztebl Int 2017; 114: 472. DOI: 10.3238/arztebl.2017.0472