Is surgery necessary for colonic fistulas and psoas abscesses in patients with Crohn's disease? A case report

INTRODUCTION AND IMPORTANCE: Crohn's disease (CD) is a chronic gastrointestinal granulomatous disease. When CD is complicated by abscess formation, the most quality of life of patients were seriously affected, especially those with intestinal fistula, intestinal stenosis or severe disease activity. CASE PRESENTATION: We present a case of a 20-year-old male with CD associated with intestinal fistula and psoas muscle abscess formation, who was successfully managed by drugs and nutrition without surgery. CLINICAL DISCUSSION: Surgery is undoubtedly the most effective treatment for CD with abscesses/fistulas. Whereas, for patients sensitive to drug therapy, abscess puncture and drainage could be considered as alternative to surgery, at this time enteral nutrition, antibiotics and immunosuppressants is particularly critical. CONCLUSION: We suggest that CD patients complicated with abscess formation in clinical, if the infection can be controlled before operation, and the abscess site is convenient for puncture and drainage, who could consider to choose comprehensive treatment like enteral nutrition, antibiotics, continuous local irrigation of the abscess cavity via the catheter and immunosuppressive agents.