Sumiyuki Sone

Liver abscess as the initial manifestation of colonic Crohn's disease: Report of a case

Liver abscess is a rare complication of Crohns disease and in most of the reported cases, the diagnosis of Crohns disease preceded that of liver abscess. We report herein a case in which a liver abscess was the initial clinical manifestation of Crohns disease in a 36 year old man who presented with high fever and weakness. The diagnosis of liver abscess was established by abdominal ultrasonography, computed tomography and an arterial blood culture. The abscess was resolved with antibiotic therapy alone and during the drug therapy, a barium enema examination was performed which revealed a stricture at the transverse colon. Resection of the transverse colon was performed and macroscopic and microscopic examination of the resected specimen established the diagnosis of Crohns disease. The liver abscess was thus speculated to be secondary to the inflamed bowel. Although rare, Crohns disease should be included in the differential diagnosis of diseases causing liver abscess.