URGENT LAPAROSCOPIC PERIRECTAL ABSCESS EVACUATION IN A PATIENT WITH CROHN’S DISEASE: A CASE REPORT
Keywords:
Crohn’s Disease, perirectal abscess, laparoscopyAbstract
Crohn’s disease is a chronic inflammatory bowel disease frequently complicated by perianal manifestations[1]. Perirectal abscess formation is a rare but potentially serious complication. We present the case of a young patient with Crohn’s disease who presented with anal pain and urinary retention caused by a large perirectal abscess. The diagnosis was established by contrast-enhanced computed tomography. Urgent laparoscopic incision and evacuation of the abscess were performed through the avascular presacral plane. Postoperatively, the patient was treated with targeted double antibiotic therapy and recovered without complications. This case highlights laparoscopic drainage as a safe and effective alternative when percutaneous or transrectal drainage is not feasible on call in the emergency setting.
References
Torres J, Mehandru S, Colombel JF, Peyrin-Biroulet L. Crohn’s disease. Lancet 2017; 389(10080): 1741-1755. doi: 10.1016/S0140-6736(16)31711-1.
Feuerstein JD, Ho EY, Shmidt E, Singh H, Falck-Ytter Y, Sultan S, et al. AGA Clinical Practice Guidelines on the Medical Management of Moderate to Severe Luminal and Perianal Fistulizing Crohn's Disease. Gastroenterology 2021; 160(7): 2496-2508. doi: 10.1053/j.gastro.2021.04.022.
Greenstein AJ, Sachar DB, Mann D, et al. Spontaneous intra-abdominal abscess in Crohn’s disease. Ann Surg 1985; 201(2): 183-190.
Kim DH, Chang KJ, Fowler KJ, Cash BD, Garcia EM, Kambadakone AR, et al. ACR Appropriateness Criteria® Crohn Disease. J Am Coll Radiol 2020; 17(5S): S81-S99. doi: 10.1016/j.jacr.2020.01.030.
Bemelman WA, Warusavitarne J, Sampietro GM, Serclova Z, Zmora O, Luglio G, et al. ECCO-ESCP Consensus on Surgery for Crohn's Disease. J Crohns Colitis 2018; 12(1): 1-16. doi: 10.1093/ecco-jcc/jjx061.
Gutierrez A, Lee H, Sands BE. Outcome of percutaneous drainage of abdominal abscesses in Crohn’s disease. Am J Gastroenterol 2006; 101(10): 2285-2289. doi: 10.1111/j.1572-0241.2006.00757.x.
Clancy C, Boland T, Deasy J, McNamara D, Burke JP. A meta-analysis of percutaneous drainage versus surgery as initial treatment of Crohn’s disease-related intra-abdominal abscess. J Crohns Colitis 2016; 10(2): 202-208. doi: 10.1093/ecco-jcc/jjv198.
da Luz Moreira A, Stocchi L, Tan E, Tekkis PP, Fazio VW. Outcomes of Crohn's disease presenting with abdominopelvic abscess. Dis Colon Rectum 2009; 52(5): 906-912. doi: 10.1007/DCR.0b013e31819f27c3.
Gore RM, Ghahremani GG, Kirsch MD, et al. Pelvic abscesses: imaging and intervention. Radiographics 2000; 20(5): 1441-1463.
Nguyen SQ, Divino CM, Nguyen DB, et al. Laparoscopic drainage of intra-abdominal abscesses. Surg Endosc 2004; 18(6): 1038-1042.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Svetozar Antovic, Vilijam Kitevski, Atanas Stojanov, Filip Stojkovski, Arijana Zenuni, Angela Bogeska , Bisera Popovska Zecevic, Kristijan Andonoski, Tamara Pak
This work is licensed under a Creative Commons Attribution 4.0 International License.
This work is licensed under CC BY 4.0 
