Spinal epidural abscess as a complication of Crohn's disease

Abstract

A 39-year-old woman with a history of Crohn’s disease presented with complaints of fever, low back pain, and right leg weakness. C-reactive protein was 91 mg/L and erythrocyte sedimentation rate was 140 mm/h. Pelvic computed tomography revealed wall thickening of the ileal loops and a gas-containing abscess in the presacral space characteristic of Crohn’s disease (Fig. 1). Computed tomography and magnetic resonance imaging of the lumbar spine demonstrated fistulae between distal ileum, sigmoid colon, and intraspinal extradural space, causing epidural abscess with air and lumbosacral spondylitis (Fig. 2). Following 10 days of medical treatment, surgery including a diverting end sigmoid colostomy and presacral abscess drainage was performed. This treatment with appropriate antibiotics conveyed recovery, without requiring spinal surgery. Spinal epidural abscess is a serious and rare complication of Crohn’s disease. It must be kept in mind along with caudal neurologic symptoms and leg pain in Crohn’s disease [1].