A Crohn’s disease rectovaginal fistula in a nine year old girl masquerading as a case of sexual abuse, and literature review

Crohn’s disease (CD) is a granulomatous inflammatory bowel disease (IBD) of unknown etiology, classically presenting with abdominal pain and diarrhea as the first symptoms. Only 5–10% of patients may have skin manifestations as the initial clue to the disease (1). We present a case of a 9 year old girl whose diagnosis of CD had been delayed due to lack of gastrointestinal (GI) symptoms, and a presentation of vulvovaginal maceration and perianal skin tags masquerading as child abuse. After thoroughly evaluating the patient, our suspicion of CD was confirmed by lower GI endoscopy.