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

Yamaguchi, Akiko; Matsui, Toshiyuki; Sakurai, ﻿Toshihiro; Ueki, Toshiharu; Nakabayashi, Shoichi; Yao, Tsuneyoshi; Futami, Kitaro; Arima, Sumitaka; Ono, Hiroyuki

doi:10.1007/s00535-003-1317-2

Cited by 90 publications

(22 citation statements)

References 12 publications

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“…No difference was observed before treatment between patients in the EN and non-EN groups with regard to patient demography, duration of CD, BMI, history of abdominal surgery, co-morbidities, prior medical therapy within three months, characteristics of IAA and laboratory values. About 48.3% of patients in this study underwent a surgical intervention after a median follow-up of 1.9 (1.1-2.9) years, which was lower than the rate of 80% reported in the study by Yamaguchi (1) in 2004. This might be due to the increasing use of interventional procedures such as percutaneous drainage over the past decade (36).…”

Section: Discussioncontrasting

confidence: 68%

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Enteral nutrition is associated with a decreased risk of surgical intervention in Crohns disease patients with spontaneous intra-abdominal abscess

et al. 2017

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Section: Discussioncontrasting

confidence: 68%

“…Consequently, the occurrence of spontaneous intra-abdominal abscess (IAA) is common in CD patients. Approximately 10% to 30% of patients with CD will spon-taneously develop IAA during the course of the illness (1,2). Management of CD patients with IAA is challenging and requires the expertise of multiple specialists working together.…”

Section: Introductionmentioning

confidence: 99%

Enteral nutrition is associated with a decreased risk of surgical intervention in Crohns disease patients with spontaneous intra-abdominal abscess

et al. 2017

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“…5–13 In this study, 23% of patients in the percutaneous drainage group required another intervention, and 15% of patients eventually required surgery. In most cases, surgery was successfully avoided.…”

Section: Discussionmentioning

confidence: 64%

“…1,6–7,11 The presence of an associated fistula was not evaluated in this study. Yamaguchi et al 10 suggested the importance of prior surgical history in evaluating patients for conservative therapy. In their study, 85% of patients successfully treated conservatively had no prior surgical history compared with 25% of patients who eventually required surgery.…”

Section: Discussionmentioning

confidence: 99%

Medical Versus Interventional Treatment of Intra-Abdominal Abscess in Patients With Crohn Disease

2017

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Background:Few studies exist to guide the treatment approach to intra-abdominal abscesses in Crohn disease, which can include antimicrobials alone or in conjunction with percutaneous drainage or surgery. The primary aim of this study is to review outcomes from different treatment approaches to intra-abdominal abscess in Crohn disease.Methods:Medical records were reviewed for patients admitted to the University of Michigan health care system with Crohn disease and intra-abdominal abscess over a 4-year period. Outcomes were compared among medical and interventional approaches. The χ2 test was used to test for statistical significance.Results:Of the 33 patients included, 13 were in the medical group and 20 were in the interventional group. Abscess recurrence/nonresolution occurred in 31% of patients in the medical group and 25% of patients in the interventional group (P = .7).Conclusions:In this study, there was no significant difference in outcome between medical and interventional therapy for intra-abdominal abscess in Crohn disease.

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“…CD is characterized by full-thickness inflammation of the bowel. Therefore, perforating complications such as an intra-abdominal abscess or a fistula, due to transmural translocation of bacteria from the diseased bowel to contiguous tissue, are common and should be regarded as serious complications during the disease course in these patients [1]. In the literature, occurrence rates for intra-abdominal abscesses vary from 10 to 30% [1].…”

Section: Introductionmentioning

confidence: 99%

Abdominal Abscess in Crohn's Disease: Multidisciplinary Management

Groof

Carbonnel

Buskens

et al. 2014

Dig Dis

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Crohn's disease (CD) is characterized by full-thickness inflammation of the bowel. For this reason, perforating complications such as intra-abdominal abscesses or fistulas are common. A concomitant intra-abdominal abscess with active CD of the small bowel is a challenging dilemma for gastroenterologists and surgeons. Since there is active and severe disease, this should be treated with immunosuppressive drugs. However, in the presence of an intra-abdominal abscess, immunosuppression can be dangerous. There are several treatment options for intra-abdominal abscesses in CD. Nowadays, the first-line treatment is antibiotic therapy with or without percutaneous drainage. Historically, patients were treated with surgical drainage. With the development of percutaneous drainage, treatment shifted to a more nonsurgical approach. Success rates for percutaneous drainage in the literature vary from 74 to 100%, and it is considered to be a relatively safe procedure. It has been reported that surgery can be avoided after successful percutaneous drainage in a variable number of patients (14-85%). If sepsis is controlled, CD medication should be started to prevent recurrence. It is important to monitor the effect upon CD lesions to avoid further perforating complications. Finally, an undrainable or small abscess can be treated with antibiotics alone, although high recurrence rates have been described with this approach. Patients with a concomitant stenosis, an enterocutaneous fistula or refractory active disease are likely to require surgery. Percutaneous drainage in combination with delayed surgery is useful to improve the patient's condition prior to surgery and is associated with less morbidity, a lower stoma rate and more limited resection. In conclusion, when feasible, percutaneous drainage and antibiotics should be the treatment of choice in patients with an intra-abdominal abscess in CD. If surgery is inevitable, this must be delayed to reduce postoperative septic complications and high stoma rates.

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

Cited by 90 publications

References 12 publications

Enteral nutrition is associated with a decreased risk of surgical intervention in Crohns disease patients with spontaneous intra-abdominal abscess

Enteral nutrition is associated with a decreased risk of surgical intervention in Crohns disease patients with spontaneous intra-abdominal abscess

Medical Versus Interventional Treatment of Intra-Abdominal Abscess in Patients With Crohn Disease

Abdominal Abscess in Crohn's Disease: Multidisciplinary Management

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

Cited by 90 publications

References 12 publications

Enteral nutrition is associated with a decreased risk of surgical intervention in Crohns disease patients with spontaneous intra-abdominal abscess

Enteral nutrition is associated with a decreased risk of surgical intervention in Crohns disease patients with spontaneous intra-abdominal abscess

Medical Versus Interventional Treatment of Intra-Abdominal Abscess in Patients With Crohn Disease

Abdominal Abscess in Crohn's Disease: Multidisciplinary Management

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Product

Resources

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Enteral nutrition is associated with a decreased risk of surgical intervention in Crohns disease patients with spontaneous intra-abdominal abscess

Enteral nutrition is associated with a decreased risk of surgical intervention in Crohns disease patients with spontaneous intra-abdominal abscess