Comparison of the long-term outcome of two therapeutic strategies for the management of abdominal abscess complicating Crohn's disease: percutaneous drainage or immediate surgical treatment

• Published in: Colorectal disease 2013-10, Vol.15 (10), p.1267-1272
• Main Authors: Lobatón, T., Guardiola, J., Rodriguez-Moranta, F., Millán-Scheiding, M., Peñalva, M., De Oca, J., Biondo, S.
• Format: Article
• Language: English
• Subjects: abdominal abscess; Abdominal Abscess - etiology; Abdominal Abscess - surgery; Adult; Crohn Disease - complications; Crohn's disease; Drainage; Female; Humans; Length of Stay; Male; Middle Aged; percutaneous drainage; Reoperation; Retrospective Studies; Salvage Therapy; Time Factors; treatment; Treatment Failure; Young Adult
• ISSN: 1462-8910; 1463-1318
• DOI: 10.1111/codi.12419

Aim The management of abdominal abscesses complicating Crohn's disease is complex and involves a difficult choice between medical, radiological and surgical procedures. The long‐term outcome was compared for two strategies for the management of abdominal abscess: percutaneous drainage (PD) followed by rescue surgery in the case of failure vs direct immediate surgery (IS). We also compared the results of IS with surgery performed after PD failure. Methods We retrospectively identified 44 patients with Crohn's disease with an abdominal abscess from January 2000 to December 2009. Therapeutic success was defined as abscess resolution and no reappearance within 1 year of follow‐up. Results The first therapeutic approach was PD in 22 cases and IS in the other 22 cases. IS had a higher therapeutic success rate than PD (95.5% vs 27.2% respectively; P