Presacral Abscess with Bilateral Sciatica in a Patient with Crohn's Disease.
- Author:
Won Chul KIM
1
;
Sang Woo KIM
;
Byoung Soung GO
;
Sung Jin MOON
;
Soung Hoon CHO
;
Chul Hyun LIM
;
Kyu Young CHOI
;
In Sik CHUNG
;
Won Kyung KANG
Author Information
- Publication Type:Case Report
- Keywords: Crohn Disease; Presacral Abscess; Sciatica
- MeSH: Abscess; Adult; Anti-Bacterial Agents; Buttocks; Constriction, Pathologic; Crohn Disease; Delayed Diagnosis; Drainage; Fistula; Humans; Ileum; Male; Mastectomy, Segmental; Mesalamine; Muscles; Neuralgia; Sciatica; Thigh
- From:Intestinal Research 2012;10(2):196-200
- CountryRepublic of Korea
- Language:Korean
- Abstract: Crohn's disease can cause intestinal strictures, perforations, fistulas, or abscesses. Although fistulas and abscesses are common complications of Crohn's disease, a presacral abscess with neuromuscular complications is very unusual. A delayed diagnosis and treatment may increase morbidity. The diagnosis is frequently delayed, because the clinical features of presacral abscess are variable and nonspecific. We experienced a case of a presacral abscess with bilateral sciatica in a 25-year-old male patient. He was diagnosed with Crohn's disease of the terminal ileum 2 months previously and has been managed with mesalazine. He visited our hospital due to pain in the buttocks and severe neuralgia in both thighs. We confirmed enteric fistulas, resulting in a presacral abscess, which extended symmetrically through both sciatic notches and the gluteus medius muscles. He was managed with antibiotics after a small bowel segmentectomy, right hemicolectomy, fistulectomy, and surgical drainage. The bilateral radicular pain resolved completely within 2 weeks of surgery. The patient has remained in remission and asymptomatic 1 year after surgery.
