Digestive Diseases and Sciences

, Volume 58, Issue 7, pp 2013–2018

Treatment of Intra-Abdominal Abscesses in Crohn’s Disease: A Nationwide Analysis of Patterns and Outcomes of Care

Original Article

DOI: 10.1007/s10620-013-2579-z

Cite this article as:
Ananthakrishnan, A.N. & McGinley, E.L. Dig Dis Sci (2013) 58: 2013. doi:10.1007/s10620-013-2579-z

Abstract

Background

Abdominal abscesses are a common complication in Crohn’s disease (CD). Percutaneous drainage of such abscesses has become increasingly popular and may deliver outcomes comparable to surgical treatment; however, such comparative data are limited from single-center studies. There have been no nationally representative studies comparing different treatment modalities for abdominal abscesses.

Methods

We identified all adult CD-related non-elective hospitalizations from the Nationwide Inpatient Sample 2007 that were complicated by an intra-abdominal abscess. Treatment modality was categorized into 3 strata—medical treatment alone, percutaneous drainage, and surgery. We analyzed the nationwide patterns in the treatment and outcomes of each treatment modality and examined for patient demographic, disease, or hospital-related disparities in treatment and outcome.

Results

There were an estimated 3,296 hospitalizations for abdominal abscesses in patients with CD. Approximately 39 % were treated by medical treatment alone, 29 % with percutaneous drainage, and 32 % with surgery with a significant increase in the use of percutaneous drainage since 1998 (7 %). Comorbidity burden, admission to a teaching hospital, and complicated Crohn’s disease (fistulae, stricture) were associated with non-medical treatment. Use of percutaneous drainage was more common in teaching hospitals. Mean time to percutaneous drainage and surgical treatment were 4.6 and 3.3 days, respectively, and early intervention was associated with significantly shorter hospitalization.

Conclusions

We describe the nationwide pattern in the treatment of abdominal abscesses and demonstrate an increase in the use of percutaneous drainage for the treatment of this subgroup. Early treatment intervention was predictive of shorter hospitalization.

Keywords

Crohn’s disease Percutaneous drainage Abdominal abscess Surgery Bowel resection 

Abbreviation

CD

Crohn’s disease

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Ashwin N. Ananthakrishnan
    • 1
    • 2
  • Emily L. McGinley
    • 3
  1. 1.Gastrointestinal UnitMassachusetts General Hospital Crohn’s and Colitis CenterBostonUSA
  2. 2.Harvard Medical SchoolBostonUSA
  3. 3.Center for Patient Care and Outcomes and ResearchMedical College of WisconsinMilwaukeeUSA

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