Osteomyelitis associated with Crohn's disease. A case report and literature review

The case of a patient with pelvic osteomyelitis in association with Crohn's disease is presented. A review of the literature is discussed. The location most frequently affected is the right ileum, but other sites may be involved. The osteomyelitis usually develops as a result of direct extention of internal fistulae, with enteric flora being the infecting organisms. The importance of resecting the diseased segment of bowel is discussed. Many patients do not require bony resection. The possibility of pelvic osteomyelitis must be considered in patients with Crohn's disease who present with suggestive symptoms and radiographic evidence of osteomyelitis. Patients who initially present with pelvic osteomyelitis should be suspected of having intraabdominal pathology.