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Clin Colon Rectal Surg 2001; 14(2): 129-134
DOI: 10.1055/s-2001-15850
Copyright © 2001 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Management of Intraabdominal Abscesses in Crohn's Disease

Thomas E. Read
  • Section of Colon and Rectal Surgery, Washington University School of Medicine, St. Louis, MO
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Publication History

Publication Date:
31 December 2001 (online)

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ABSTRACT

Traditionally, patients with intraabdominal or pelvic abscesses arising as a consequence of Crohn's disease have been managed by open surgical drainage. However, advances in cross-sectional imaging and interventional radiological techniques have resulted in the increasing use of percutaneous drainage as an initial step in the management of these patients. After the septic focus is controlled, the patient's nutritional status can be optimized and inflammation reduced to permit an elective definitive operation at a later time. The amount of bowel resected and the rate of stoma creation are probably reduced because of the advantage of operating in an uninfected field without severe acute inflammation. In addition, some patients may be managed with percutaneous drainage and medical therapy alone. Initial reluctance on the part of interventional radiologists to drain complex abscesses is being replaced by enthusiasm to treat abscesses related to enteric fistulas, multiloculated collections, and multifocal abscesses. The combination of percutaneous drainage combined with preoperative bowel rest and nutritional support can convert difficult emergent operations into safe elective procedures.

KEYWORD

Crohn's disease - abscess - percutaneous drainage - total parenteral nutrition - treatment

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