CT-guided percutaneous pelvic abscess drainage in Crohn's disease.
BACKGROUND
Percutaneous abscess drainage (PAD) is the current therapy for abdominal or pelvic collections. PAD has poorer curative rate for abscesses in Crohn's disease (CD), commonly complicated by wide fistulas and multiloculations.


METHODS
We retrospectively evaluated abscess cure rate, complications and final outcome in 87 CD patients, 70 with spontaneous and 17 with postoperative pelvic abscesses, all treated with CT-guided PAD during the last 7 years.


RESULTS
A 77% primary success rate and an 84.3% secondary success rate were obtained without major complications. The higher success rate for PAD was for postoperative (88.2%) rather than spontaneous abscesses (74.2%). Seventy-two percent of treated patients did not develop recurrent abscesses and underwent elective surgery up to 40 months later.


CONCLUSIONS
PAD in pelvic abscess complicating CD is an effective alternative to early surgery with satisfactory curative success rates. In unsuccessful cases, due to wide fistulas or postoperative anastomotic dehiscence, PAD helped in planning elective surgery, reducing surgical complications.
Golfieri
R
R
Department of Radiology, Policlinico S. Orsola-Malpighi, University of Bologna, Italy. golfieri@aosp.bo.it
Cappelli
A
A
Giampalma
E
E
Rizzello
F
F
Gionchetti
P
P
Laureti
S
S
Poggioli
G
G
Campieri
M
M
D000038:Abscess / Q000150:complications / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D003424:Crohn Disease / Q000601:surgery*; D004322:Drainage; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D034161:Pelvic Infection / Q000150:complications / Q000601:surgery*; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome