Gluteal and Presacral Abscess Due to Crohn's Disease with Multiple Fistulas.
Hui Jeong JwaHyun Joo SongHogyung JunSeong Taeg KimSun-Jin BooHeung Up KimDonghyoun LeePublished in: The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi (2022)
The abscess is a common complication of Crohn's disease (CD), with the perianal form more frequent than gluteal or presacral which is relatively rare. There are few case reports of gluteal abscess combined with presacral abscess caused by CD and the treatment has not been established. A 21-year-old male was admitted with right buttock and lower back pain with a duration of 3 months. He had a history of CD in the small intestine diagnosed 10 months previously. He had poor compliance and had not returned for follow-up care during the previous 6 months. Abdominopelvic CT indicated newly developed multiple abscess pockets in right gluteal region, including piriformis muscle and presacral space. Additionally, fistula tracts between small bowel loops and presacral space were observed. Patient's CD was moderate activity (273.12 on the Crohn's Disease Activity Index [CDAI]). Treatment was started with piperacillin/ tazobactam antibiotic but patient developed a fever and abscess extent was aggravated. Therefore, surgical incision and drainage was performed and 4 Penrose drains were inserted. Patient's pain and fever were resolved following surgery. Infliximab was then administered for the remaining fistulas. After the induction regimen, multiple fistula tracts improved and patient went into remission (CDAI was -0.12).
Keyphrases
- case report
- disease activity
- rheumatoid arthritis
- rare case
- systemic lupus erythematosus
- small bowel
- healthcare
- computed tomography
- chronic pain
- nk cells
- minimally invasive
- rheumatoid arthritis patients
- pain management
- magnetic resonance
- magnetic resonance imaging
- coronary artery disease
- palliative care
- skeletal muscle
- neuropathic pain
- juvenile idiopathic arthritis
- spinal cord injury
- coronary artery bypass
- atrial fibrillation
- percutaneous coronary intervention
- positron emission tomography
- multidrug resistant