Percutaneous Abscess Drainage in Crohn Disease: Technical Success and Short- and Long-term Outcomes during 14 Years

Gervais, Debra A.; Hahn, Peter F.; O’Neill, Margaret; Müeller, Peter R.

doi:10.1148/radiol.2223010554

Cited by 142 publications

(128 citation statements)

References 13 publications

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“…This article focuses on the former. Approximately 10% to 30% of patients with Crohn's disease will spontaneously develop an abdominal or pelvic abscess during the course of their illness [1][2][3] . These abscesses occur from transmural inflammation and microperforation of diseased bowel [4,5] .…”

Section: Epidemiology and Pathogenesismentioning

confidence: 99%

“…If fever persists, a repeat CT is indicated to assure that the catheter is properly positioned. The catheter can be removed when drainage decreases to 10-20 mL per day [3,24] . The mean time for drainage is approximately 7-10 d (range 3 to 23 d) [8,20] .…”

Section: Computed Tomography Guided Percutaneous Abscess Drainagementioning

confidence: 99%

“…Generally, success is defined as resolution of symptoms with collapse of the abscess cavity and avoidance of early surgery (within 30-60 d) [3,5,10,20,28,29] . With this definition in mind, success rates vary from 50%-95% [3,5,8,19,23] . Multiple or multi-locular abscesses and those associated with a fistula are more often prone to failure [3,8,29] .…”

Section: Success Of Percutaneous Abscess Drainagementioning

confidence: 99%

“…With this definition in mind, success rates vary from 50%-95% [3,5,8,19,23] . Multiple or multi-locular abscesses and those associated with a fistula are more often prone to failure [3,8,29] . Also, spontaneous Figure 1 A 33-year-old female patient with a 3 cm pelvic abscess due to Crohn's disease.…”

Section: Success Of Percutaneous Abscess Drainagementioning

confidence: 99%

“…One argument favoring elective surgery is that diseased bowel left intact is a focus for future abscess recurrence, perhaps requiring emergency surgery at a later date. In one study, only 23% of patients avoided a definitive operation after a mean follow-up of 7.2 years [3] . In another study, 6 of 7 patients that did not have elective surgery had a severe recurrence within 3 years [1] .…”

Section: Timing Of Surgerymentioning

confidence: 99%

See 4 more Smart Citations

Management of abdominal and pelvic abscess in Crohn’s disease

Richards

2011

WJGE

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Patients with Crohn's disease may develop an abdominal or pelvic abscess during the course of their illness. This process results from transmural inflammation and penetration of the bowel wall, which in turn leads to a contained perforation and subsequent abscess formation. Management of patients with Crohn's related intra-abdominal and pelvic abscesses is challenging and requires the expertise of multiple specialties working in concert. Treatment usually consists of percutaneous abscess drainage (PAD) under guidance of computed tomography in addition to antibiotics. PAD allows for drainage of infection and avoidance of a two-stage surgical procedure in most cases. It is unclear if PAD can be considered a definitive treatment without the need for future surgery. The use of immune suppressive agents such as anti-tumor necrosis factor-α in this setting may be hazardous and their appropriate use is controversial. This article discusses the management of spontaneous abdominal and pelvic abscesses in Crohn's disease.

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Section: Epidemiology and Pathogenesismentioning

confidence: 99%