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Canadian Journal of Gastroenterology and Hepatology
Volume 2017, Article ID 5124354, 8 pages
Review Article

Aseptic Abscesses and Inflammatory Bowel Disease: Two Cases and Review of Literature

1Division of Gastroenterology, Women’s College Hospital, Toronto, ON, Canada
2Division of Gastroenterology, St. Michael’s Hospital, Toronto, ON, Canada
3Division of Infectious Disease, St. Michael’s Hospital, Toronto, ON, Canada
4Department of Medical Imaging, St. Michael’s Hospital, Toronto, ON, Canada

Correspondence should be addressed to Samir C. Grover; ac.otnorotu@revorg.rimas

Received 18 August 2016; Revised 22 December 2016; Accepted 22 January 2017; Published 6 February 2017

Academic Editor: Helmut Neumann

Copyright © 2017 Natasha Bollegala et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Aseptic abscesses (AA) are sterile lesions that represent an extraintestinal manifestation (EIM) of inflammatory bowel disease (IBD). Though Canada has the highest prevalence of IBD in the world, reports of IBD-associated AA are absent in Canada. This may represent a different IBD phenotype or underrecognition and underreporting. Purpose. To explore AA as a possible EIM of IBD and evaluate clinical and investigative findings among patients with IBD-associated AA. Methods. Retrospective chart and literature reviews were performed to find cases of IBD-associated AA at our institution and in the literature. Results. We identified 2 cases of IBD-associated AA in our institution. Both patients had ulcerative colitis and presented with fever, abdominal pain, and weight loss. Radiological workup and aspiration showed sterile splenic abscesses. The AA were unresponsive to antibiotics. One patient improved on corticosteroids and one underwent splenectomy. We retrieved 37 cases of IBD-associated AA from the literature. All patients showed no evidence of infection, failed to resolve with antibiotics, and, if attempted, improved on corticosteroids. Conclusions. Our cases are the first reported in Canada. They support literature which suggests AA as an EIM of IBD and may help increase recognition and reporting of this phenomenon.