International Journal of Colorectal Disease

, Volume 27, Issue 2, pp 199–206 | Cite as

The outcome of initial percutaneous drainage versus surgical drainage for intra-abdominal abscesses in Crohn’s disease

  • Ying Xie
  • Weiming ZhuEmail author
  • Ning Li
  • Jieshou Li
Original Article



Percutaneous drainage (PD) of Crohn’s related abscesses is becoming popular with the development of techniques. We retrospectively analyzed the outcome of initial PD versus initial surgical drainage for intra-abdominal abscesses in Crohn’s disease.


Twenty-three patients of Crohn’s disease complicated with intra-abdominal or pelvic abscesses treated in our institution between July 2001 and April 2010 were retrospectively identified from 188 patients with proven Crohn’s disease. Outcome measures included abscess recurrence after different treatments, post-drainage complications, ultimate stoma creation, and subsequent surgery for Crohn’s disease.


Patients were divided into initial PD group (n = 10) and initial surgery group (n = 13): post-drainage complications were more common in initial surgery group (2/10 vs 9/13, P = 0.036), abscess recurred in three patients (2/10 vs 1/13, NS), and subsequent surgery was needed in 10 patients (6/10 vs 4/13, NS). Ultimate stoma creation were significantly more in initial surgery group (1/10 vs 9/13, P = 0.01).


Initial PD group had lower rate of post-drainage complications and ultimate stoma creation compared to the initial surgery group. Although subsequent surgery may not be avoided after PD, it can provide safe anastomosis for resections. Long-term follow-up should be done to assess the outcome of PD.


Crohn’s disease Abscess Percutaneous drainage Stoma creation Subsequent surgery Post-drainage complication 



Percutaneous drainage


Crohn’s disease


Computed tomography




Continuous irrigation and aspiration drainage


Enteral nutrition


Parenteral nutrition


Standard deviation


Body mass index


White blood cell




C reactive protein


Erythrocyte sedimentation rate




Crohn’s disease activity index



This work was partly supported by the National Natural Science Foundation of China (number 30972881). ZWM and LN designed the experiment, XY collected and analyzed the data and wrote the manuscript, and LJS gave the provision of significant advice or consultation. All authors read and approved the final manuscript.


  1. 1.
    Keighley MRB, Eastwood D, Ambrose NBS, Allan RN, Burdon DW (1982) Incidence and microbiology of abdominal and pelvic abscesses in Crohn’s disease. Gastroenterology 83:1271–1275PubMedGoogle Scholar
  2. 2.
    Greenstein AJ, Sachar DB, Greenstein RJ, Janowitz HD, Aufses AH (1982) Intraabdominal abscess in Crohn’s (ileo) colitis. Am J Surg 143:727–730PubMedCrossRefGoogle Scholar
  3. 3.
    Casola G, Van Sonnenberg E, Neff CC, Saba RM, Withers C, Emarine CW (1987) Abscesses in Crohn’s disease: percutaneons drainage. Radiology 163:19–22PubMedGoogle Scholar
  4. 4.
    Rypens F, Dubois J, Garel L, Deslandres C, Saint-Vil D (2007) Percutaneous drainage of abdominal abscesses in pediatric Crohn’s disease. AJR Am J Roentgenol 188:579–585PubMedCrossRefGoogle Scholar
  5. 5.
    Poritz LS, Koltun WA (2007) Percutaneous drainage and leocolectomy for spontaneous intraabdominal abscess in Crohn’s disease. J Gastrointest Surg 11:204–208PubMedCrossRefGoogle Scholar
  6. 6.
    Garcia JC, Persky SE, Bonis PA, Topazian M (2001) Abscesses in Crohn’s disease: outcome of medical versus surgical treatment. J Clin Gastroenterol 32:409–412PubMedCrossRefGoogle Scholar
  7. 7.
    Gervais DA, Hahn PF, O’Neill MJ, Mueller PR (2002) Percutaneous abscess drainage in Crohn disease: technical success and short- and long-term outcomes during 14 years. Radiology 222:645–651PubMedCrossRefGoogle Scholar
  8. 8.
    Yamaguchi A, Matsui T, Sakurai T et al (2004) The clinical characteristics and outcome of intraabdomina abscess in Crohn’s disease. J Gastroenterol 39:441–448PubMedCrossRefGoogle Scholar
  9. 9.
    Jawhari A, Kamm MA, Ong C, Forbes A, Bartram CI, Hawley PR (1998) Intra-abdominal and pelvic abscess in Crohn’s disease: results of noninvasive and surgical management. Br J Surg 85:367–371PubMedCrossRefGoogle Scholar
  10. 10.
    da Luz MA, Stocchi L, Tan E, Tekkis PP, Fazio VW (2009) Outcomes of Crohn’s disease presenting with abdominopelvic abscess. Dis Colon Rectum 52:906–912CrossRefGoogle Scholar
  11. 11.
    Safrit HD, Mauro MA, Jaques PF (1987) Percutaneous abscess drainage in Crohn’s disease. AJR Am J Roentgenol 148:859–862PubMedGoogle Scholar
  12. 12.
    Georgopoulos F, Mylonaki M, Malgarinos G, Malli Ch, Fouskas J, Panteris V, Cheracakis P, Merikas E, Peros G, Triantafillidis JK (2008) Intraabdominal abscesses in patients with Crohn’s disease: clinical data and therapeutic manipulations in 17 cases of a single hospital setting. Ann Gastroenterol 21:188–192Google Scholar
  13. 13.
    Agrawal A, Durrani S, Leiper K, Ellis A, Morris AI, Rhodes JM (2005) Effect of systemic corticosteroid therapy on risk for intra-abdominal or pelvic abscess in non-operated Crohn’s disease. Clin Gastroenterol Hepatol 3:1215–1220PubMedCrossRefGoogle Scholar
  14. 14.
    Yamamoto T, Allan RN, Keighley MR (2000) Risk factors for intra-abdominal sepsis after surgery in Crohn’s disease. Dis Colon Rectum 43:1141–1145PubMedCrossRefGoogle Scholar
  15. 15.
    Yamamoto T, Keighley MR (2000) Smoking and disease recurrence after operation for Crohn’s disease. Br J Surg 87:398–404PubMedCrossRefGoogle Scholar
  16. 16.
    Alamili M, Gogenur I, Rosenberg J (2009) Acute complicateddiverticulitis managed by laparoscopic lavage. Dis Colon Rectum 52(7):1345–1349PubMedCrossRefGoogle Scholar
  17. 17.
    Alves A, Panis Y, Joly F et al (2004) Could immunosuppressive drugs reduce recurrence rate after second resection for Crohn disease? Inflamm Bowel Dis 10:491–495PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  1. 1.Department of General Surgery, Jinling HospitalMedical School of Nanjing UniversityNanjingChina

Personalised recommendations