Crohn's Disease Complicating Psoas Abscess Expanded to Upper Thigh: Report of a Case

Koji Nishijima, Masato Kiriyama, Hiroshi Itoh, Toru Ii, Yoshiyuki Kurosaka, Shigeru Takegawa, Shotaro Dohba, Yasuhiko Kojima and Kishichiro Watanabe^*

Department of Surgery and Pathology^*, National Kanazawa Hospital

A 20-year-old male with a 6-year history of Crohn's disease presented with right femoral pain and swelling. A diagnosis of right femoral abscess extending from a psoas abscess was made based on the findings of an MRI examination and a gastrograffin enema. He had been received percutaneous drainage for a right femoral abscess at the age of 19 years. A laparotomy was performed, revealing swelling and stiffening of the terminal ileum and cecum; the right femoral abscess had expanded from a psoas abscess and a retroperitoneal abscess. Surgical drainage of the abscess cavity and ileocecal resection was performed. The resected specimen showed signs of Crohn's ileocolitis, with an external fistula in the appendix that was considered to have caused the abscess. The patient had an uneventful recovery and has remained well without any recurrence of symptoms for 6 years since his operation. Although the expansion of a psoas abscess to the femoral area is rare complication in Japan, the increasing prevalence of Crohn's disease has made this condition an important complication requiring surgical intervention.

Key words
Crohn's disease, psoas abscess, femoral abscess

Reprint requests
Koji Nishijima Department of Surgery, National Kanazawa Hospital 1-1 Shimoishibiki-cho, Kanazawa, 920-8650 JAPAN

Accepted
June 25, 2003

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