Inflammatory bowel diseases, particularly Crohn’s disease and ulcerative colitis, represent some of the most challenging conditions in contemporary gastroenterology. These disorders are associated with significant complications and a high tendency toward chronicity. Onset typically occurs during childhood or early adulthood. The immune system plays a central role in the pathogenesis of inflammatory bowel diseases; however, the precise mechanisms involved remain incompletely understood. It is well established that dysregulation of the immune response to the intestinal microbiota is a key factor contributing to the development of chronic inflammation.

Aim: to demonstrate the features and challenges of diagnosing Crohn’s disease in children.

Material and methods. The case of an 11-year-old girl who was admitted to the hospital with symptoms of systemic inflammation, abdominal pain, hepatomegaly, and other signs mimicking a viral-bacterial infection is presented. Laboratory tests and endoscopy revealed inflammatory changes in the gastrointestinal tract characteristic of Crohn’s disease. However, histopathological examination did not show classical signs of the disease. The diagnosis of Crohn’s disease was made based on a comprehensive analysis of clinical manifestations and examination results.

Conclusions. Chronic inflammatory bowel diseases remain a diagnostic challenge in children due to their variable presentation. A meticulous evaluation of patient complaints and medical history, integrated with a comprehensive assessment of physical examination findings supported by auxiliary diagnostic methods, and guided by adherence to established diagnostic standards, minimizes the risk of misdiagnosis and supports the selection of the most appropriate treatment strategy.