title: Image-guided Percutaneous Drainage for Treatment of Post-Surgical Anastomotic Leak in Patients with Crohn's Disease.
abstract: OBJECTIVE
  Anastomotic leaks with abscess formation are a common complication after bowel surgery in Crohn's disease patients. Image-guided percutaneous drainage is an attractive alternative to reoperation because of decreased morbidity and length of hospital stay. Because data for this specific population are scarce, the purpose of this study is to determine the safety and efficacy of image-guided percutaneous drainage in the management of post-surgical anastomotic leak in patients with Crohn's disease.
  
  
  METHODS
  A total of 41 patients who underwent percutaneous drain placement for the treatment of fluid collections due to anastomotic leak from September 2004 to November 2013 were retrospectively identified from the electronic medical record and picture archiving and communication system. Data recorded included number, size, and location of anastomotic leaks, number of drains placed, number of follow-up visits, post-drainage complications, abscess resolution, and subsequent surgeries.
  
  
  RESULTS
  In all, 41 patients with 76 fluid collections were identified as having received percutaneous drains. The mean number of targeted fluid collections per patient was 1.5, and the mean duration between surgery and percutaneous drain placement was 18.5 days. The mean number of drains placed was 1.6, and the median drain size was 10 French [range 8-16 French]. One of 41 [2.4%] patients experienced a minor complication from drain placement [injury to a superficial abdominal artery] and no major complications occurred. Two of 41 [4.9%] patients required repeat surgeries.
  
  
  CONCLUSIONS
  Image-guided percutaneous drainage for the treatment of post-surgical anastomotic leaks in Crohn's patients is effective and safe, with low rates of complications and reoperations.
authors.affiliation: School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: James
authors.initials: J
authors.lastname: Byrne
authors.affiliation: School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Ryan
authors.initials: R
authors.lastname: Stephens
authors.affiliation: Department of Radiology, Division of Vascular Interventional Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA ari_isaacson@med.unc.edu.
authors.forename: Ari
authors.initials: A
authors.lastname: Isaacson
authors.affiliation: Department of Radiology, Division of Vascular Interventional Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Hyeon
authors.initials: H
authors.lastname: Yu
authors.affiliation: Department of Radiology, Division of Vascular Interventional Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Burke
mesh_terms: D018784:Abdominal Abscess / Q000000981:diagnostic imaging / Q000601:surgery*; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D057868:Anastomotic Leak / Q000000981:diagnostic imaging / Q000601:surgery*; D015331:Cohort Studies; D003082:Colectomy / Q000009:adverse effects* / Q000379:methods; D003287:Contrast Media; D003424:Crohn Disease / Q000175:diagnosis / Q000601:surgery*; D004322:Drainage / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery; D011856:Radiographic Image Enhancement; D012189:Retrospective Studies; D018570:Risk Assessment; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
chemical_list: D003287:Contrast Media
keywords: Crohn’s disease; abscess; anastomotic leak; bowel surgery; percutaneous drainage