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Intest Res > Volume 10(2); 2012 > Article
Intestinal Research 2012;10(2):196-200.
DOI: https://doi.org/10.5217/ir.2012.10.2.196    Published online April 30, 2012.
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
크론병에서 양측 좌골신경통을 동반한 천골전 농양
김원철, 김상우, 고병성, 문성진, 조성훈, 임철현, 최규용, 정인식, 강원경
가톨릭대학교 의과대학 내과학교실, 외과학교실
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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