A clinical case of ulcerative colitis complicated by rectal stenosis in a 14-year-old child. Case report

Inflammatory bowel diseases (IBD) include two main entities: ulcerative colitis (UC) and Crohn's disease (CD). Despite the awareness of specialists, the knowledge of pathogenesis, and advances in diagnostics, there are still patients in whom the clinical, endoscopic, and histological presentation does not fully correspond to one of the diseases, which is defined as undifferentiated colitis. Subsequently, some of these cases are verified as UC or CD; however, other patients are followed up for a long time with an uncertain diagnosis. Nevertheless, differential diagnosis is crucial for the choice of therapeutic tactics, risk assessment of surgical treatment, and prognosis of colorectal cancer. The article aims to demonstrate the challenges of differential diagnosis of UC and CD in a child with rectal stenosis. In the described case, low compliance in a girl with UC led to significant errors in traditional therapy regimens, the development of complications that irreversibly change the anatomical structure of the colon and complicate the examination, mimicking the course of stenosing CD. The clinical case emphasizes the need for more detailed criteria for differential diagnosis and additional therapeutic algorithms, with an earlier use of genetically engineered biological agents as disease-modifying therapy.