Percutaneous drainage of abscesses in patients with Crohn disease

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.…”

The clinical impact of preoperative percutaneous drainage of abdominopelvic abscesses in patients with Crohn’s disease

“…The potential downsides of PD include a longer duration of treatment as seen in the current study as well as others [13,25] and potentially an increase in morbidity when PD fails [25]. The need for surgery following PD of Crohn's-related intra-abdominal abscesses ranges from 20% to 86% in the literature, depending on the length of follow-up and whether or not postoperative abscesses are considered [12,13,15,16,24,[26][27][28][32][33][34]. In an early report by Casola et al, surgery was avoided in 12 of 15 Crohn's disease patients who had abdominal abscesses treated with PD, including four with fistulous connections between their abscess cavities and loops of bowel [27].…”

“…This is not surprising, as most surgeons would not delay in intervening when persistent sepsis is present. Previous reports have demonstrated a lower success rate when PD is used to treat Crohn's-related abdominopelvic abscesses with documented enteric fistulization [12,15,[27][28][29]. Other reported predictors of PD failure include steroids [17,29], spontaneous vs. postoperative abscesses [13][14][15][16], and multiple abscesses [17].…”

Psoas abscess complicating Crohn’s disease: Report of a case

“…Jawhari et al 11 reported that 2 of 8 Crohn's disease-related psoas abscesses were successfully treated by percutaneous drainage alone with longterm remission. Safrit et al 23 and Lambiase et al 24 reported 18 and nine cases of percutaneous abscess drainage, respectively, and concluded that the procedure was a valuable technique for treating Crohn's disease-related abscesses. After control of the abscess has been achieved, definitive surgery including resection of the fistulous bowel can be performed in a clean field.…”