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KMID : 0988920120100020196
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Intestinal Research
2012 Volume.10 No. 2 p.196 ~ p.200
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Presacral Abscess with Bilateral Sciatica in a Patient with Crohn’s Disease
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Kim Won-Chul
Kim Sang-Woo
Go Byoung-Soung
Moon Sung-Jin
Cho Soung-Hoon
Lim Chul-Hyun
Choi Gyu-Yong
Chung In-Sik
Kang Won-Kyung
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Abstract
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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.
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KEYWORD
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Crohn Disease, Presacral Abscess, Sciatica
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