Intra-abdominal and pelvic abscess in Crohn's disease: results of noninvasive and surgical management.
BACKGROUND
Intra-abdominal and pelvic abscesses occur in 10-30 per cent of patients with Crohn's disease. The aim of this study was to establish the clinical characteristics and outcome of patients admitted over a 4-year period with an abdominal or pelvic abscess secondary to Crohn's disease.


METHODS
Patients with Crohn's disease-related intra-abdominal or pelvic abscess were identified from a prospectively collected database, comprising all admissions between 1991 and 1994. Medical records were reviewed retrospectively and data gathered regarding management and outcome.


RESULTS
Thirty-six patients were identified with Crohn's disease-related abscess, of whom 15 were considered for initial percutaneous drainage. Drainage was technically possible in eight of these patients: it failed in four, gave good long-term results in two, and was followed by recurrence after 3 years in one and by later surgery unrelated to the abscess in one. Twenty-eight patients underwent surgery, with only four requiring a stoma. Complications occurred in 12 patients. At 3 months, 22 of the 36 patients were in remission.


CONCLUSIONS
Crohn's intra-abdominal abscesses are associated with a high morbidity rate. Selected cases can be drained percutaneously, without adding to the morbidity, and sometimes resulting in abscess resolution.
Jawhari
A
A
Department of Surgery, St. Mark's Hospital, Northwick Park, Harrow, UK.
Kamm
M A
MA
Ong
C
C
Forbes
A
A
Bartram
C I
CI
Hawley
P R
PR
D018784:Abdominal Abscess / Q000209:etiology* / Q000601:surgery / Q000628:therapy; D000038:Abscess / Q000209:etiology* / Q000601:surgery / Q000628:therapy; D000328:Adult; D017668:Age of Onset; D000368:Aged; D003424:Crohn Disease / Q000150:complications* / Q000601:surgery / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010388:Pelvis; D011446:Prospective Studies; D016659:Psoas Abscess / Q000209:etiology / Q000601:surgery / Q000628:therapy; D012008:Recurrence; D013203:Staphylococcal Infections / Q000209:etiology* / Q000628:therapy