Right-sided sciatalgia complicating Crohn's disease.
Neurological complications of Crohn's disease due to involvement of the extradural space are extremely rare. A 40-yr-old woman with Crohn's disease affecting the terminal ileum presented with a right-sided sciatalgia. The patient did not complain of diarrhea or constipation. The serum fibrinogen and the C-reactive protein were elevated. Magnetic resonance imaging and computed tomography scan of the abdomen and pelvis demonstrated a mass in front of the sacrum up to but not including the first sacral vertebra. Surgical intervention, with resection of 15 cm of terminal ileum, led to the complete resolution of symptoms. In this case, the underlying cause of the neurological symptoms was most likely an infiltration of the right lumbosacral nerve caused by edema and inflammation of the terminal ileum in the vicinity of the presacral space. Unexplained lumbosacral neurological symptoms in a patient with Crohn's disease necessitate a magnetic resonance imaging or computed tomography scan to detect potential neurological compression.
Demarquay
J F
JF
Department of Gastroenterology and Radiology, Archet II Hospital, C.H.U. Nice, France.
Caroli-Bosc
F X
FX
Buckley
M
M
Peten
E P
EP
Chevallier
P
P
Hebuterne
X
X
Delmont
J P
JP
D000328:Adult; D003424:Crohn Disease / Q000150:complications* / Q000601:surgery; D004824:Epidural Space; D005260:Female; D006801:Humans; D007079:Ileitis / Q000150:complications / Q000601:surgery; D009408:Nerve Compression Syndromes / Q000209:etiology*