Adult studies indicated that people with isolated colonic Crohn’s disease (L2 CD) have distinct features that distinguish them from patients with ileocaecal Crohn’s disease (L1) and ulcerative colitis (UC). For a study, researchers sought to define the clinical characteristics and outcomes of pediatric patients with L2. The Porto Inflammatory Bowel Disease group of the European Society for Pediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) collected retrospective data on Pediatric patients with L2, L1, or UC at various time periods. Time to first flare, hospital admissions, beginning of anti-tumor necrosis factor-alpha (TNFα) medication, stricture, and surgery were all outcome variables. 

There were a total of 300 patients: 102 L1, 94 L2, and 104 UC. For patients with L1, L2, and UC, the rates of hematochezia were 14.%, 44.7%, and 95.2%, respectively, whereas the rates of fever were 12.7%, 26.6%, and 2.9% (P< 0.001 for all comparisons). Skip lesions were seen in 66% of L2 patients, whereas granulomas were found in 36% of L1 patients. Anti-Saccharomyces cerevisiae antibodies (ASCA) and perinuclear antineutrophil cytoplasmic (pANCA) positivity rates differed significantly between the three groups: 25.4% and 16.7% for patients with L2, compared to 55.2% and 2.3%, and 1.8% and 52.9%, respectively, for patients with L1 and UC. The response rates to exclusive enteral feeding (78.3–82.4%) were comparable across L1 and L2, as was the reaction to oral steroids (70.4–76.5%) in the 3 groups. While the timeframes to first flare and hospitalization were comparable between groups, patients with L1 were started on anti-TNF treatment earlier. Furthermore, the stricturing phenotype and the requirement for colectomy were quite uncommon in L2 patients. Clinical presentation and outcomes of Pediatric children with L2 differed significantly from those of kids with L1 and UC.