Abscesses in Crohn's disease: Outcome of medical versus surgical treatment

Outcomes of Crohn's Disease Presenting with Abdominopelvic Abscess

“…Other authors have reported more frequently primary surgery to treat CD-related abscesses, 3,5,10 and this has been described as even more effective than PD in treating CD-related abdominopelvic abscesses. 3 Considering our management approach it is also not surprising that our selected population undergoing primary surgery experienced relatively high stoma creation rates. It is plausible that our stoma creation rates would have decreased if we had more liberally treated patients with initial surgery as opposed to PD.…”

“…The present study is similar to prior studies showing a PD success rate ranging from 50 to 96 percent. 3,6Y9 This wide range of success rates in the literature depends on a variety of factors including different abscess types, abscess locations, and definitions of PD failure. For example, in some series postoperative and spontaneous abdominopelvic abscesses have been considered combined, although the PD success rate for postoperative abscess is higher than after spontaneous CD-related abscess.…”

“…4 Other authors have suggested that PD can be successful without additional surgery. 3,6,9 For example, Golfieri et al have shown long-term benefits with no abscess recurrence for a median follow-up of 40 months after successful PD and drain discontinuation. 11 Unfortunately, our data does not allow us to make any meaningful comparisons to these previous studies because our management has preferentially consisted of elective surgery following PD.…”

Surgical management of pyogenic complications of Crohnʼs disease

“…Numerous studies have looked at the success rates and outcomes of percutaneous drainage, with many reporting that initial treatment with percutaneous drainage is safe and successful in up to 70% of cases. [59][60][61][62] However, surgical drainage has been found to be more effective than percutaneous drainage for prevention of abscess recurrence, 60 with one-third of patients treated with percutaneous drainage requiring surgery by 1 year. 62,63 The benefits of preoperative drainage include allowing time to improve the patient's nutritional status, converting the operative field into a noninfected area, and decreasing use of steroids, all of which are independent risk factors for increased complications after an operation.…”

Standardtherapie bei Morbus Crohn

“…"Sparsame" Operationen bleiben für Patienten mit Komplikationen, therapierefraktären Verläufen und Fisteln vorbehalten. Intraabdominelle Abszesse können häu-fig sonographisch oder CT-gesteuert drainiert werden [16]. Die Ballondilatation kurzstreckiger Stenosen im Kolon oder terminalen Ileum haben sich, nach adäquater Schubtherapie, als ähnlich wirksam wie eine Strikturoplastik erwiesen [17].…”