RIGHT-SIDED SCIATALGIA COMPLICATING CROHNS-DISEASE

Neurological complications of Crohn's disease due to involvement of th e extradural space are extremely rare, A 40-yr-old woman with Crohn's disease affecting the terminal ileum presented with a right-sided scia talgia. The patient did not complain of diarrhea or constipation. The serum fibrinogen and the C-reactive protein were elevated. Magnetic re sonance imaging and computed tomography scan of the abdomen and pelvis demonstrated a mass in front of the sacrum up to but not including th e first sacral vertebra. Surgical intervention, with resection of 15 c m of terminal ileum, led to the complete resolution of symptoms. In th is case, the underlying cause of the neurological symptoms was most li kely an infiltration of the right lumbosacral nerve caused by edema an d 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. (C) 1998 by Am. Cell. of Gastroenterology.