Fistulizing Crohn’s Disease Complicated by Hidden Retroperitoneal Abscess: A Case Report and Review of the Literature

Abstract

Crohn’s Disease (CD) is a chronic inflammatory disorder of the intestinal tract characterized by trans-mural damage of the bowel wall often complicated by strictures, entero-visceral and perianal fistulae and abscesses. Both computed tomography and magnetic resonance enable clear visualization of the involved intestinal tract together with various extra- and intra intestinal complications. Herewith, the uncommon case of a hidden retroperitoneal abscess with para-vertebral collection, as a consequence of a penetrating CD of the terminal ileum, is described. Retrofascial collections, due to fistulizing CD, are rare events often misdiagnosed or even recognized late in the clinical course and associated with severe and potentially life threatening consequences. Prompt assessment with cross-sectional imaging is necessary. MR imaging is being more frequently used in the follow-up of CD since the lack of ionizing radiations which avoids any biological impact in these patients.