title: Influence of percutaneous abscess drainage on severe postoperative septic complications in patients with Crohn's disease.
abstract: OBJECTIVE
  Severe postoperative intra-abdominal septic complications (IASC) such as an anastomotic leak, intra-abdominal abscess, and fistula are significantly associated with the presence of spontaneous intra-abdominal abscess at the time of laparotomy in patients with Crohn's disease (CD). The purpose of this study was to compare the incidence of severe postoperative IASC in patients undergoing intestinal resections with and without preoperative percutaneous abscess drainage (PAD) before definitive surgery.
  
  
  METHODS
  Using a prospective surgical database, we searched for patients with CD and spontaneous intra-abdominal abscesses who underwent intestinal resection at our hospital from May 2005 to February 2009. Postoperative IASC were defined as anastomotic leaks, abscess, and fistula within 1 month after surgery. We compared the incidence of postoperative IASC in patients with (group I) and without (group II) preoperative PAD (Fisher's exact test).
  
  
  RESULTS
  We identified 25 patients (15 men, 10 women; mean age, 31 years) with spontaneous intra-abdominal abscesses. PAD was performed in 12 of 25 patients (48%), with an average of 37 days before surgery (range, 6-83 days). The overall rate of postoperative IASC was 48% (12 of 25 patients). In group I, postoperative IASC occurred in 3 of 12 patients (25%). In group II, postoperative IASC were assessed in 9 of 13 patients (69%). The differences between these two groups were considered to be statistically significant (p = 0.04).
  
  
  CONCLUSIONS
  PAD of intra-abdominal abscesses before surgery could significantly reduce the occurrence of severe postoperative IASC in patients with CD.
authors.affiliation: Department of Radiology, University Medical Center Regensburg, Regensburg, Germany. rene.mueller-wille@klinik.uni-regensburg.de
authors.forename: René
authors.initials: R
authors.lastname: Müller-Wille
authors.forename: Igors
authors.initials: I
authors.lastname: Iesalnieks
authors.forename: Christian
authors.initials: C
authors.lastname: Dornia
authors.forename: Claudia
authors.initials: C
authors.lastname: Ott
authors.forename: Ernst Michael
authors.initials: EM
authors.lastname: Jung
authors.forename: Chris
authors.initials: C
authors.lastname: Friedrich
authors.forename: Gabriela
authors.initials: G
authors.lastname: Schill
authors.forename: Patrick
authors.initials: P
authors.lastname: Hoffstetter
authors.forename: Niels
authors.initials: N
authors.lastname: Zorger
authors.forename: Andreas G
authors.initials: AG
authors.lastname: Schreyer
mesh_terms: D018784:Abdominal Abscess / Q000150:complications / Q000601:surgery*; D015746:Abdominal Pain / Q000150:complications / Q000000981:diagnostic imaging; D000293:Adolescent; D000328:Adult; D003424:Crohn Disease / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D004322:Drainage; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery; D011859:Radiography; D018805:Sepsis / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery*; D055815:Young Adult