Diagnosis and management of psoas abscess in Crohn's disease

Four patients with Crohn's disease complicated by psoas abscess are described. These patients did not have general or abdominal signs of sepsis but they all showed wasting of the right quadriceps femoris and hip flexion. It is important to examine the hip and thigh in patients with known Crohn's disease who are on medical treatment. Surgical treatment of a Crohn's psoas abscess should include resection of recurrent disease, fashioning of the anastomosis remote from the abscess cavity, and long-term (21 days) drainage of the abscess cavity to avoid the possibilities of faecal fistula or recurrent abscess.