ABSTRACT
The delayed diagnosis of musculoskeletal complications of Crohn's disease may produce major morbidity in patients. This study compared abdominal and pelvic computed tomography (CT) with conventional radiography in the diagnosis of musculoskeletal complications in 23 of 552 patients with Crohn's disease examined by CT over a 7-year period. Surgical confirmation was available in 15 of 21 patients. The clinical features of psoas/gluteal abscesses, abdominal wall fistulae, and sacral osteomyelitis are described. Because the clinical manifestations of these musculoskeletal complications are often nonspecific, CT is often useful in diagnosing and directing therapeutic interventions.
Subject(s)
Crohn Disease/complications , Musculoskeletal Diseases/diagnostic imaging , Musculoskeletal Diseases/etiology , Tomography, X-Ray Computed , Abdominal Muscles/diagnostic imaging , Adolescent , Adult , Child , Cutaneous Fistula/diagnostic imaging , Cutaneous Fistula/etiology , Female , Humans , Intestinal Fistula/diagnostic imaging , Intestinal Fistula/etiology , Male , Psoas Abscess/diagnostic imaging , Psoas Abscess/etiologyABSTRACT
In 1991, only symptomatic gallstones should be treated. The treatment of choice for all gallstones continues to be surgical removal. Except for stones in the common bile duct, which are amenable to removal by endoscopic papillotomy, nonsurgical treatment of gallstones should be investigated further before it can have widespread applicability. The major challenge in the future may be medical prevention of gallstone formation in susceptible individuals. Laparoscopic cholecystectomy seems to have moved to the forefront of surgical therapy in patients who are candidates for the procedure.
