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. 2025 Feb 27;19(1):120-126.
doi: 10.1159/000543761. eCollection 2025 Jan-Dec.

Aseptic Abscess Syndrome: A Case Report of a Rare Extraintestinal Manifestation of Inflammatory Bowel Disease

Clive Jude Miranda  1 , Nariman Hossein-Javaheri  2 , Gina Marie Sparacino  2 , Yousef Soofi  2 , Farhan Azad  3 , Nikki Duong  4
Affiliations

Aseptic Abscess Syndrome: A Case Report of a Rare Extraintestinal Manifestation of Inflammatory Bowel Disease

Clive Jude Miranda et al. Case Rep Gastroenterol. .

Abstract

Introduction: Aseptic hepatic abscesses are a highly uncommon phenomenon and even more rare in the spectrum of extraintestinal manifestations of inflammatory bowel disease. Part of the spectrum of "neutrophilic disease," both the pathogenesis and the optimal management of these aseptic abscesses remain unclear. In the context of inflammatory bowel disease, sometimes these abscesses appear despite normal endoscopic findings.

Case presentation: We describe a highly uncommon case of aseptic hepatic abscess formation in a patient with inflammatory bowel disease.

Conclusion: In doing so, we investigated the concept of "aseptic abscess syndrome" as it relates to similar autoimmune conditions.

Keywords: Aseptic hepatic abscess; Crohn’s disease; Hepatic abscess; Inflammatory bowel disease.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1.
Fig. 1.
High-power (×400) H&E microscopy image showing colonic mucosa with focal active inflammation (intraepithelial neutrophils and focal crypt abscess) to formally establish the patient’s diagnosis of Crohn’s.
Fig. 2.
Fig. 2.
Initial transverse CT image showing a subcapsular 2.4 × 2.3 × 1.7 cm rim-enhancing abscess within segment 5 of the liver with central and peripheral hypodensity.
Fig. 3.
Fig. 3.
Coronal image of the initial CT also showing a subcapsular 2.4 × 2.3 × 1.7 cm rim-enhancing abscess within segment 5 of the liver with central and peripheral hypodensity.
Fig. 4.
Fig. 4.
Repeat CT (transverse and coronal) images showing an increase in abscess size, now measuring 3.4 × 3.3 × 3.1 cm, prior to percutaneous drainage.
Fig. 5.
Fig. 5.
Repeat CT (transverse and coronal) images showing an increase in abscess size, now measuring 3.4 × 3.3 × 3.1 cm, prior to percutaneous drainage.
Fig. 6.
Fig. 6.
Unremarkable colonoscopy just after percutaneous drainage of the hepatic abscess.
See this image and copyright information in PMC

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