TY - JOUR
AR - AJSCR-2019-1-104
TI - Iliopsoas Abscess as the First Clinical Manifestation of Crohn’s Disease - A Rare Case Report and Literature Review
AU - Abdul, Waheed
AU - Cristiano, Alpendre
AU - Kai, Huang
AU - Nikita, Sijapati
AU - Subhasis, Misra
JO - American Journal of Surgical Case Reports
PY - 2019
DA - Sat 28, Dec 2019
SN - 2674-5046
DO - http://dx.doi.org/10.31487/j.AJSCR.2019.01.04
UR - https://www.sciencerepository.org/lliopsoas-abscess-as-the-first-clinical-manifestation-of-crohn-s-disease_AJSCR-2019-1-104 
KW - Iliopsoas abscess, crohn’s disease, percutaneous drainage, fistula, surgical management
AB - Objective: Iliopsoas abscess is a rare complication of fistulizing Crohn’s disease, which is difficult to
diagnose and manage. We report this case to alert clinicians to the diagnosis and management of this unusual
association.
Case presentation: A 31-year-old male who presented with right groin pain, and hip pain due to an iliopsoas
abscess. He was found to have iliopsoas fistula and underlying Crohn’s disease. The right iliopsoas abscess
was managed with CT guided percutaneous drainage and pigtail catheter placement and intravenous
antibiotics. The patient was started on mesalamine and prednisone. A month later, the patient became
symptomatic again and a duodenocolic fistula was found. A laparoscopic extended right hemicolectomy
with both fistulas takes-down, end ileostomy and mucus fistula were performed. Pathology revealed chronic
active Crohn’s ileocolitis. His ileostomy was reversed three months later. The patient recovered
uneventfully and was doing well after six-month follow-up.
Conclusions: Iliopsoas abscess can be a rare presentation of Crohn’s disease. Evaluation with CT imaging,
and initial management with drainage and antibiotics are recommended. Surgical intervention should be
considered early for impending arthritis.