Intra-abdominal and pelvic abscess in Crohn's disease: results of noninvasive and surgical management

Br J Surg. 1998 Mar;85(3):367-71. doi: 10.1046/j.1365-2168.1998.00575.x.


Background: Intra-abdominal and pelvic abscesses occur in 10-30 per cent of patients with Crohn's disease. The aim of this study was to establish the clinical characteristics and outcome of patients admitted over a 4-year period with an abdominal or pelvic abscess secondary to Crohn's disease.

Methods: Patients with Crohn's disease-related intra-abdominal or pelvic abscess were identified from a prospectively collected database, comprising all admissions between 1991 and 1994. Medical records were reviewed retrospectively and data gathered regarding management and outcome.

Results: Thirty-six patients were identified with Crohn's disease-related abscess, of whom 15 were considered for initial percutaneous drainage. Drainage was technically possible in eight of these patients: it failed in four, gave good long-term results in two, and was followed by recurrence after 3 years in one and by later surgery unrelated to the abscess in one. Twenty-eight patients underwent surgery, with only four requiring a stoma. Complications occurred in 12 patients. At 3 months, 22 of the 36 patients were in remission.

Conclusion: Crohn's intra-abdominal abscesses are associated with a high morbidity rate. Selected cases can be drained percutaneously, without adding to the morbidity, and sometimes resulting in abscess resolution.

MeSH terms

  • Abdominal Abscess / etiology*
  • Abdominal Abscess / surgery
  • Abdominal Abscess / therapy
  • Abscess / etiology*
  • Abscess / surgery
  • Abscess / therapy
  • Adult
  • Age of Onset
  • Aged
  • Crohn Disease / complications*
  • Crohn Disease / surgery
  • Crohn Disease / therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Pelvis*
  • Prospective Studies
  • Psoas Abscess / etiology
  • Psoas Abscess / surgery
  • Psoas Abscess / therapy
  • Recurrence
  • Staphylococcal Infections / etiology*
  • Staphylococcal Infections / therapy