Skip to main content

Advertisement

SpringerLink
Log in

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

  • Original Article
  • Published:
International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

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.

Methods

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.

Results

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).

Conclusions

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Abbreviations

PD:

Percutaneous drainage

CD:

Crohn’s disease

CT:

Computed tomography

US:

Ultrasound

CIAD:

Continuous irrigation and aspiration drainage

EN:

Enteral nutrition

PN:

Parenteral nutrition

SD:

Standard deviation

BMI:

Body mass index

WBC:

White blood cell

PLT:

Platelet

CRP:

C reactive protein

ESR:

Erythrocyte sedimentation rate

ALB:

Albumin

CDAI:

Crohn’s disease activity index

References

  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 83:1271–1275

    PubMed  CAS  Google Scholar 

  2. Greenstein AJ, Sachar DB, Greenstein RJ, Janowitz HD, Aufses AH (1982) Intraabdominal abscess in Crohn’s (ileo) colitis. Am J Surg 143:727–730

    Article  PubMed  CAS  Google Scholar 

  3. Casola G, Van Sonnenberg E, Neff CC, Saba RM, Withers C, Emarine CW (1987) Abscesses in Crohn’s disease: percutaneons drainage. Radiology 163:19–22

    PubMed  CAS  Google Scholar 

  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 188:579–585

    Article  PubMed  Google Scholar 

  5. Poritz LS, Koltun WA (2007) Percutaneous drainage and leocolectomy for spontaneous intraabdominal abscess in Crohn’s disease. J Gastrointest Surg 11:204–208

    Article  PubMed  Google Scholar 

  6. Garcia JC, Persky SE, Bonis PA, Topazian M (2001) Abscesses in Crohn’s disease: outcome of medical versus surgical treatment. J Clin Gastroenterol 32:409–412

    Article  PubMed  CAS  Google Scholar 

  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 222:645–651

    Article  PubMed  Google Scholar 

  8. Yamaguchi A, Matsui T, Sakurai T et al (2004) The clinical characteristics and outcome of intraabdomina abscess in Crohn’s disease. J Gastroenterol 39:441–448

    Article  PubMed  Google Scholar 

  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 85:367–371

    Article  PubMed  CAS  Google Scholar 

  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 52:906–912

    Article  Google Scholar 

  11. Safrit HD, Mauro MA, Jaques PF (1987) Percutaneous abscess drainage in Crohn’s disease. AJR Am J Roentgenol 148:859–862

    PubMed  CAS  Google Scholar 

  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 21:188–192

    Google Scholar 

  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 3:1215–1220

    Article  PubMed  CAS  Google Scholar 

  14. Yamamoto T, Allan RN, Keighley MR (2000) Risk factors for intra-abdominal sepsis after surgery in Crohn’s disease. Dis Colon Rectum 43:1141–1145

    Article  PubMed  CAS  Google Scholar 

  15. Yamamoto T, Keighley MR (2000) Smoking and disease recurrence after operation for Crohn’s disease. Br J Surg 87:398–404

    Article  PubMed  CAS  Google Scholar 

  16. Alamili M, Gogenur I, Rosenberg J (2009) Acute complicateddiverticulitis managed by laparoscopic lavage. Dis Colon Rectum 52(7):1345–1349

    Article  PubMed  Google Scholar 

  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 10:491–495

    Article  PubMed  Google Scholar 

Download references

Acknowledgment

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.

Author information

Authors and Affiliations

  1. Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Road, Nanjing, 210002, China

    Ying Xie, Weiming Zhu, Ning Li & Jieshou Li

Authors
  1. Ying Xie
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Weiming Zhu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ning Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jieshou Li
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Weiming Zhu.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Xie, Y., Zhu, W., Li, N. et al. The outcome of initial percutaneous drainage versus surgical drainage for intra-abdominal abscesses in Crohn’s disease. Int J Colorectal Dis 27, 199–206 (2012). https://doi.org/10.1007/s00384-011-1338-x

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00384-011-1338-x

Keywords

Search

Navigation