Lamport R D, Cheskin L J, Moscatello S A, Nikoomanesh P
Division of Gastroenterology, Johns Hopkins School of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Maryland.
Am J Gastroenterol. 1994 Jul;89(7):1086-9.
Crohn's disease primarily affects the distal gastrointestinal tract, yet it is a systemic disease that can involve nearly any organ. A psoas abscess complicating Crohn's disease is uncommon and usually originates from a fistulous communication with an adherent bowel. Spinal epidural abscess, an extremely rare complication, also appears to arise by fistulization from another organ involved with Crohn's disease. Previous reports indicate that abscesses in these two areas usually contain bacterial organisms, often mixed flora, consistent with seeding from a diseased bowel. This report represents the first case of Crohn's disease complicated by both bilateral sterile psoas abscesses and a coexistent sterile epidural abscess without evidence of a fistulous communication from the bowel. We report this case because psoas and epidural abscesses can present without typical signs and symptoms. Once suspected, aggressive diagnostic workup and definitive operative intervention is indicated. Failure to promptly diagnose and treat these abscesses may result in considerable morbidity.
克罗恩病主要累及远端胃肠道，但它是一种全身性疾病，几乎可累及任何器官。克罗恩病并发腰大肌脓肿并不常见，通常源于与粘连肠段的瘘管相通。脊柱硬膜外脓肿是一种极其罕见的并发症，似乎也由克罗恩病累及的其他器官通过瘘管形成。既往报道表明，这两个部位的脓肿通常含有细菌，常为混合菌群，与来自病变肠段的播散一致。本报告介绍了首例克罗恩病并发双侧无菌性腰大肌脓肿及并存无菌性硬膜外脓肿且无肠瘘管相通证据的病例。我们报告该病例是因为腰大肌和硬膜外脓肿可能无典型的体征和症状。一旦怀疑，应积极进行诊断性检查并进行确定性手术干预。未能及时诊断和治疗这些脓肿可能导致相当大的发病率。
