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.