Sistema de Salut de Catalunya
Institut Català de la Salut
[El-Hussuna A] OpenSourceResearch Collaboration, Aalborg, Denmark. [Steenholdt C] Department of Gastroenterology, Herlev Hospital, Herlev, Denmark. [Merrild Karer ML, Nyggard Uldall Nielsen N] Department of Surgery, Aalborg University, Aalborg, Denmark. [Mujukian A, Fleshner PR] Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA. [Pellino G] Unitat de Cirurgia de Còlon i Recte, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania “Luigi Vanvitelli,” Naples, Italy
Vall d'Hebron Barcelona Hospital Campus
2023-09-04T12:21:17Z
2023-09-04T12:21:17Z
2023-07
Crohn’s disease; Abscess; Stoma
Malaltia de Crohn; Abscés; Estoma
Enfermedad de Crohn; Absceso; Estoma
Background Management of spontaneous intra-abdominal abscess (IAA) in patients with Crohn’s disease (CD) with radiologically guided percutaneous drainage (PD) was debated. Methods This is a secondary analysis from a multicenter, retrospective cohort study of all the patients with CD who underwent PD followed by surgery at 19 international tertiary centers. Results Seventeen patients (4.8%) who did not undergo surgery after PD were compared to those who had PD followed by surgical intervention 335/352 (95.2%). Patients who had PD without surgery were those with longer disease duration, more frequently had previous surgery for CD (laparotomies/laparoscopies), enteric fistula, on steroid treatment before and continue to have it after PD. Patients who had PD without subsequent surgical resection had a higher risk of stoma construction at later stages 8/17 (47.1%) versus 90/326 (27.6%) (P < .01). Patients with PD with no subsequent surgery had numerically higher rates of abscess recurrence 5/17 (29.4%) compared to those who had PD followed by surgery 45/335 (13.4%) the difference was not statistically significant (P = .07). Conclusions Even with the low number of patients enrolled in this study who had PD of IAA without subsequent surgery, the findings indicate a markedly worse prognosis in terms of recurrence, length of stay, readmission, and stoma construction. Watchful waiting after PD to treat patients with spontaneous IAA might be indicated in selected patients with poor health status or poor prognostic factors.
Article
Published version
English
Crohn, Malaltia de; Abdomen - Abscessos; Drenatge quirúrgic; DISEASES::Digestive System Diseases::Gastrointestinal Diseases::Gastroenteritis::Inflammatory Bowel Diseases::Crohn Disease; DISEASES::Bacterial Infections and Mycoses::Infection::Suppuration::Abscess::Abdominal Abscess; Other subheadings::Other subheadings::Other subheadings::/diagnostic imaging; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Surgical Procedures, Operative::Drainage; ENFERMEDADES::enfermedades del sistema digestivo::enfermedades gastrointestinales::gastroenteritis::enfermedad inflamatoria intestinal::enfermedad de Crohn; ENFERMEDADES::infecciones bacterianas y micosis::infección::supuración::absceso::absceso abdominal; Otros calificadores::Otros calificadores::Otros calificadores::/diagnóstico por imagen; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::intervenciones quirúrgicas::drenaje
Oxford University Press
Crohn's & Colitis 360;5(3)
https://doi.org/10.1093/crocol/otad038
Attribution-NonCommercial 4.0 International
http://creativecommons.org/licenses/by-nc/4.0/
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