摘要 : A 63-year-old man with a 1-year history of ileocolitic Crohn's disease presented with fever (38deg C) and left lower quadrant pain of 5 days' duration. On examination, a tender egg-sized round mass was palpable in the left lower a... 展开 A 63-year-old man with a 1-year history of ileocolitic Crohn's disease presented with fever (38deg C) and left lower quadrant pain of 5 days' duration. On examination, a tender egg-sized round mass was palpable in the left lower abdomen. The white blood cell count was 15.5 X 10~9/L (normal: 4-9 X 10~9/L) and C-reactive protein was 18.95 mg/dL(<0.27 mg/dL). CT revealed a mesenteric abscess adjunct to the sigmoid colon. A Gastrografin(Nihon Schering, Osaka, Japan) enema study showed irregular luminal narrowing of the sigmoid colon, suggesting the inflammatory change caused by the extraintestinal lesion. Colonoscopy disclosed an elevated mass, which presumably was pressed by the abscess, with tiny aphthoid lesions in the sigmoid colon. The spontaneous drainage of whitish pus from the inflamed mass was observed. Biopsy specimens showed only an inflammatory infiltration. Prior colonoscopy 4 months earlier had confirmed a longitudinal ulcer scar and no diverticula in the affected area. Intravenous administration of antibiotics resulted in a reduction in the size of the abscess, and the patient recovered uneventfully. He has been treated with mesalazine, and the abscess has not recurred during the follow-up period. 收起