Ischemic colitis in a child: a case report and narrative review.

Introduction: Ischemic colitis is extremely rare in preschool-aged children and is still susceptible to misdiagnosis due to atypical symptoms. Misdiagnosis can have serious consequences, including delayed treatment and disease progression, so raising clinical awareness of this condition is critical. This report aims to contribute by providing a relevant case and a narrative overview of ischemic colitis in children. Case presentation: A 6-year-old boy presented with recurrent hematochezia for 6 days and mild abdominal pain. Laboratory tests showed elevated inflammatory markers. Colonoscopy revealed segmental mucosal congestion and erosions in the descending and sigmoid colon; pathology confirmed chronic active mucosal inflammation. After excluding infectious colitis and inflammatory bowel disease, ischemic colitis was diagnosed. Conservative management with bowel rest, intravenous fluids, and mucosal protective agents achieved complete symptom resolution without recurrence. Conclusion: In conjunction with the accompanying narrative overview, this case underscores that ischemic colitis, though rare, must be considered in the differential diagnosis of unexplained hematochezia in preschool children. The favorable outcome achieved through conservative management aligns with the broader literature synthesis, reinforcing that non-surgical intervention is both feasible and effective in this demographic. This review of the available evidence further highlights the critical need for heightened clinical suspicion to avoid delayed intervention.