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A 17-year-old male with Crohn's disease presented with persistent fever and right upper quadrant tenderness. Ultrasonography and abdominal computerized axial tomography (CAT scan) showed two large loculated abscess cavities in the right lobe of the liver. Surgical drainage and antibiotic therapy led to resolution of both cavities over a 5-month period. Unlike six previously reported patients, our patient had no evidence of pylephlebitis or mesenteric abscess formation at surgery. We speculate that his abscesses arose through seeding of mesenteric vessels and portal bacteremia.
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