Abstract
Background: Pediatric Crohn’s disease (CD) presents with variable gastrointestinal and systemic symptoms and is often diagnosed late. Objective: To describe the clinical characteristics, laboratory and endoscopic findings, treatment approaches, and early outcomes among children aged 3–15 years diagnosed with CD at a tertiary center in Libya. Methods: A cross-sectional observational study using retrospectively collected data, the study was conducted at the Department of Pediatric Gastroenterology and Hepatology, Tripoli University Hospital, Tripoli, Libya, between 2023 and 2025 of 40 children diagnosed with CD. Data included demographics, clinical presentation, growth, labs, endoscopy, histopathology, treatment, and outcomes. Results: Diarrhea (97.5%), abdominal pain (95%), fever (90%), and weight loss (87.5%) were common. Growth impairment was seen in 72.5%. Lab abnormalities included anemia (85%), high CRP (95%), high ESR (80%), and low albumin (62.5%). Terminal ileum involvement was seen in 95%. All received steroids and azathioprine; 60% received Biological therapy. Remission achieved in 85%; relapses in 15%. Conclusion: Pediatric CD in this cohort showed prolonged symptoms, growth impairment, and severe inflammation. Despite challenges, early remission was common with appropriate therapy. Improved early recognition and expanded access to diagnostics and biologics are essential.