Abscesses in Crohn's disease. Outcome of medical versus surgical treatment

Juan Carlos Garcia, Seth E. Persky, Peter A L Bonis, Mark Topazian

Research output: Contribution to journalArticle

89 Scopus citations

Abstract

Goals: To compare the long-term outcome of medical, percutaneous, and surgical treatment of abdominal and pelvic abscesses complicating Crohn's disease. Study: All patients with Crohn's disease and an abdominal abscess treated at one institution during a 10-year period were retrospectively identified. We reviewed hospital and outpatient records and contacted patients for telephone interviews. Outcome measures included abscess recurrence, subsequent surgery for Crohn's disease, and medications used at the time of most recent follow-up. Results: Fifty-one subjects were identified, with a mean follow-up of 3.75 years. Fewer patients developed recurrent abscesses after initial surgical drainage and bowel resection (12%) than patients treated with medical therapy only or percutaneous drainage (56%) (p = 0.016). One half of the patients treated nonoperatively ultimately required surgery, whereas only 12% of those treated with initial surgery required reoperation during the follow-up period (p = 0.010). Most failures of nonoperative therapy occurred within 3 months. Medication use was similar between the treatment groups at the time of most recent follow-up. Conclusions: In this series, surgical management of abscesses in Crohn's disease was more effective than medical treatment or percutaneous drainage for prevention of abscess recurrence. However, nonoperative therapy prevented subsequent surgery in half of the patients and may be a reasonable treatment option for some patients.

Original languageEnglish (US)
Pages (from-to)409-412
Number of pages4
JournalJournal of Clinical Gastroenterology
Volume32
Issue number5
DOIs
StatePublished - 2001
Externally publishedYes

Keywords

  • Abscess
  • Crohn's disease
  • Treatment

ASJC Scopus subject areas

  • Gastroenterology

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