Incidence and Microbiology of Abdominal and Pelvic Abscess in Crohn's Disease

Spontaneous abdominopelvic abscess as an initial manifestation of Crohn's disease: A retrospective cohort review

“…2,3 The ileocecal region was the most common site of AP development in the CD group, which is congruent with previous studies. 2,3,18 The proposed mechanisms underlying the formation of the spontaneous AP abscesses mentioned in the literature include (i) transmural bowel inflammation with fistulization, (ii) direct penetration of bacteria from the bowel lesion to contiguous tissue via perforation sites and (iii) remote (hematologic) seeding of bacteria from the diseased bowel. 19 The strength of the current study is that the relationship of the abscess with the bowel lesion was examined histologically in four-fifths of the patients with newly diagnosed CD.…”

“…Abdominopelvic (AP) abscess occurs in 10-30% of the patients with CD in the Western countries and can affect the peritoneum (including the pelvis) and retroperitoneum such as psoas abscesses. [1][2][3][4] It usually forms in dependent portions of the peritoneal cavity such as paracolic gutters, pelvis or subdiaphragmatic and intermesenteric region of the bowel. 2 In addition, AP abscess may be an initial presenting feature of CD, however, its clinical characteristics and treatment outcomes are poorly described in the literature.…”

Abdominal phlegmons in Crohnʼs disease: Outcomes following antitumor necrosis factor therapy

“…The penetration is thought to arise from direct extension of the transmural inflammation through the bowel wall. Approximately 10% of CD patients will develop an abdominal or pelvic abscess over the course of their illness 17. The perforation may be sealed off by a localized inflammatory reaction resulting in the formation of an inflammatory mass or phlegmon, which may contain discrete fluid collections and involve adjacent segments of bowel with possible fistula formation.…”

Psoas abscess complicating Crohn's disease

“…2,3 Studies suggest the majority of psoas abscesses are secondary and pyogenic in origin with CD being the most common aetiology. 2,6,8 CD is an inflammatory bowel disease characterized by transmural inflammation which may result in perforation of the bowel wall. Abscesses in CD arise most commonly from the ileocaecal region and patients may present with a right iliac fossa mass.…”

“…If perforation occurs, bacteria can enter the retroperitoneal space with an iliopsoas abscess being the end result. 9,10 Intra-abdominal abscesses are reported to occur in 6.8-28% of patients with CD, 8,9,11,12 but the figures for iliopsoas abscesses in CD sufferers is between 0.4 and 5%. 1,10,[12][13][14] Furthermore, the mortality from psoas abscess complicating CD has been reported to be as high as 10.4%.…”