Presacral Abscess with Bilateral Sciatica in a Patient with Crohn's Disease |
Won Chul Kim, Sang Woo Kim, Byoung Soung Go, Sung Jin Moon, Soung Hoon Cho, Chul-Hyun Lim, Kyu Young Choi, In-Sik Chung, Won Kyung Kang |
Departments of Internal Medicine and Surgery, The Catholic University of Korea College of Medicine, Seoul, Korea
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크론병에서 양측 좌골신경통을 동반한 천골전 농양 |
김원철, 김상우, 고병성, 문성진, 조성훈, 임철현, 최규용, 정인식, 강원경 |
가톨릭대학교 의과대학 내과학교실, 외과학교실 |
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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. (Intest Res 2012;10: 0-200) |
Key Words:
Crohn Disease, Presacral Abscess, Sciatica |
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