Intra-abdominal Abscess in Regional Enteritis

Abstract

Intra-abdominal abscess (IAA) developed in 129 of 610 patients (21.2%) with Crohn's disease confined to the small bowel. The location of the abscess was intraperitoneal (IPA) in 109 (17.9%) and retroperitoneal (RPA) in 20 (3.3%). There was a marked preponderance of male patients in the retroperitoneal group (ratio, 18:2) (p less than 0.0001). All 129 patients were operated on. Thirteen of one hundred nine patients (12%) with IPA were reoperated on for recurrent abscess, and nine (8.2%) for other reasons. External fistula developed in 24 patients (22%) after simple incision and drainage. Four (3.7%) died; one from hepatitis, and three from sepsis 5, 14, and 90 days after surgery. Of the 20 patients with RPA, two (10%) were reoperated on for recurrent abscess and four (20%) for other reasons. External fistula developed in two patients (10%). There were no deaths in this group. A small number of patients with IAA complicating regional enteritis had persistent sepsis causing postoperative death, which is, however, six times lower than in our comparable series of Crohn's (ileo)colitis.

The clinical characteristics and outcome of intraabdominal abscess in Crohn?s disease

“…Reports from Europe and the United States on the same subject note that the incidence of abscess ranges from 10% to 30% in patients with CD; 1-5 the complication of an abscess occurred at a mean age of 35 years; 5 the duration of illness (CD) preceding the abscess formation was 4 to 16 years. [2][3][4][5] These studies concluded that the incidence of an abdominal abscess increased in proportion to the duration of CD. 12,13 However, no reports refer to the cumulative incidence of abscess.…”

“…According to the literature from western countries, its occurrence is between 10% and 30%, [1][2][3][4][5] but in Japan, the only study on the subject, presented by Maeda et al, 6 who conducted a survey by questionnaire, reported that the incidence was 8.9%. Many of the patients with abscess formation complicating CD were subjected to surgical treatment: only a few have been treated with conservative methods.…”

Inflammatory Bowel Disease in Korea: Epidemiological, Genomic, Clinical, and Therapeutic Characteristics

“…The lifetime risk for intraabdominal abscess in CD patients is approximately 25%. 121 Almost all abscesses require drainage either surgically or percutaneously. Although there is controversy as to whether or not intraabdominal CD abscess should be managed surgically, surgical resection is required when an abscess has enteric contents.…”

Small intestine contrast ultrasonography (SICUS) for the detection of small bowel complications in crohnʼs disease: A prospective comparative study versus intraoperative findings

“…20,21 Surgery remains an important component of treatment of CD and an accurate preoperative assessment of CD lesions and associated complications is required to plan the surgical approach and intervention. [22][23][24] Such preoperative assessment is even more important when using a laparoscopic approach that may limit the surgeons manual search for subtle lesions of the intestine.…”