Multiple Aseptic Liver Abscesses as the Initial Manifestation of Crohn's Disease: Report of a Case

Aseptic liver abscesses preceding the diagnosis of Crohn's disease are extremely rare. We report a patient with multiple liver abscesses that yielded negative microbiologic investigation and failed to develop full remission under antibiotic therapy. Diagnosis of Crohn's disease of small and large bowel was later established and she was started on sulfasalazine and azathioprine with total regression of the hepatic abscesses. This case illustrates the rare possibility of aseptic liver abscesses as an initial manifestation of Crohn's disease, which could be interpreted in the light of recent data on aberrant homing of gut T memory/effector lymphocytes in the liver.