Two large liver abscesses complicating Crohn’s disease*

Summary

A 20-year-old woman with active Crohn’s disease had an abrupt onset of high fever accompanied by an elevation of serum γ-glutamyltransferase and alkaline phosphatase. Her past medical history included a course of corticosteroid therapy for 7.5 months and a resection of the terminal ileum and the cecum 2 months before admission. At that time an ileoascendostomy had been performed, revealing a walled-off perforation of the colon into the retroperitoneal space. Sonography revealed 2 large abscesses in the right lobe of the liver. After beginning antibiotics, ultrasound-guided percutaneous aspiration and drainage with a pigtail catheter were performed for both abscesses leading to a rapid reduction of their size and an improvement in the patients general condition. Liver abscess represents a rare complication of Crohn’s disease. A review of the literature is presented.

Zwei große Leberabszesse als Komplikation eines M. Crohn

Bei einer 20-jährigen Patientin mit einem floriden M. Crohn kam es plötzlich zu hohem Fieber und einem Anstieg der γ-Glutamyltransferase und alkalischen Phosphatase. Sonographisch wurden 2 große Abszesse im rechten Leberlappen diagnostiziert. Nach antibiotischer Anbehandlung wurden beide Abszesse unter sonographischer Kontrolle punktiert und mit einem Pigtail-Katheter drainiert. Sie bildeten sich danach rasch zurück. Vorausgegangen waren eine 7,5-monatige Therapie mit Kortison und eine 2 Monate zurückliegende Resektion der Ileozökalregion mit Ileoaszendostomie, wobei eine retroperitoneal gedeckte Perforation des Kolons zu Tage gefördert wurde. Ein Leberabszess stellt eine seltene Komplikation des M. Crohn dar. Die diesbezügliche Literatur wird in einer Übersicht dargestellt.

Liver Abscess - Crohn’s Disease - Percutaneous Catheter Drainage

Leberabszess - M. Crohn - perkutane Katheterdrainage

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Fußnoten

1 Dedicated to Prof. Dr. Georg Strohmeyer on the occasion of his 70^th birthday

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