Purpose: Percutaneous abscess drainage (PAD) is the fi rst-line approach for abscess in Crohn’s disease (CD) since it procrastinates or avoids surgery especially in postoperative abscesses [within 30 days postoperative (p.o.)]. We retrospectively evaluated the eff ectiveness, complications and outcome after PAD in postoperative and spontaneous abscesses and factors infl uencing the outcomes. Methods: We performed PAD in 91 abscesses, 45 (49,5%) postoperative and 46 (50,5%) spontaneous. We defi ned the overall success (OS) as clinical (CS) and technical success (TS) when imaging documented the resolution of the abscess with no surgery within 30 days. Conversely, patients without abscess at the time of surgery, were considered as TS but clinical failure (CF). We also analyzed the overall failure (OF) defi ned as CF with or without technical failure (TF). Overall technical success (OTS) was OS plus TS. Complications were classifi ed as major and minor according to the Interventional Radiology Criteria. Results: In postoperative abscesses we found 91% OS, 9% OF, no TF and 100% OTS. In spontaneous abscesses we found 33% OS, 67% OF, 6.4% TF, 95,6% OTS. A total abscess resolution was achieved in 97,8% of patients. No major complication occurred; only 1 case of minor complication. Factors statistically infl uencing the outcome were postoperative vs spontaneous collections (OF: 9% vs. 67%, p < 0.0001), multiloculated vs uniloculated collections (OF: 38% vs. 1%, p < 0.0001) and upper abdominal vs lower location (OF: 13% vs. 25%, p <0.05). Conclusion: Our data confi rms the safety and eff ectiveness of PAD even in cases needing surgery within 30 days; most remarkable, PAD allows avoidance of early reoperation in almost all the patients with postoperative abscess.

Percutaneous abdomino-pelvic abscess drainage in complicated Crohn’s disease

Silvio Laureti;Nunzia Capozzi;Cristina Mosconi;Giuliano Peta;Silvia Lo Monaco;Antonio Bruno;Giulio Vara;Caterina De Benedittis;Paolo Gionchetti;Fernando Rizzello;Gilberto Poggioli;Rita Golfieri
2020

Abstract

Purpose: Percutaneous abscess drainage (PAD) is the fi rst-line approach for abscess in Crohn’s disease (CD) since it procrastinates or avoids surgery especially in postoperative abscesses [within 30 days postoperative (p.o.)]. We retrospectively evaluated the eff ectiveness, complications and outcome after PAD in postoperative and spontaneous abscesses and factors infl uencing the outcomes. Methods: We performed PAD in 91 abscesses, 45 (49,5%) postoperative and 46 (50,5%) spontaneous. We defi ned the overall success (OS) as clinical (CS) and technical success (TS) when imaging documented the resolution of the abscess with no surgery within 30 days. Conversely, patients without abscess at the time of surgery, were considered as TS but clinical failure (CF). We also analyzed the overall failure (OF) defi ned as CF with or without technical failure (TF). Overall technical success (OTS) was OS plus TS. Complications were classifi ed as major and minor according to the Interventional Radiology Criteria. Results: In postoperative abscesses we found 91% OS, 9% OF, no TF and 100% OTS. In spontaneous abscesses we found 33% OS, 67% OF, 6.4% TF, 95,6% OTS. A total abscess resolution was achieved in 97,8% of patients. No major complication occurred; only 1 case of minor complication. Factors statistically infl uencing the outcome were postoperative vs spontaneous collections (OF: 9% vs. 67%, p < 0.0001), multiloculated vs uniloculated collections (OF: 38% vs. 1%, p < 0.0001) and upper abdominal vs lower location (OF: 13% vs. 25%, p <0.05). Conclusion: Our data confi rms the safety and eff ectiveness of PAD even in cases needing surgery within 30 days; most remarkable, PAD allows avoidance of early reoperation in almost all the patients with postoperative abscess.
ANNALS OF CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
Alberta Cappelli , Silvio Laureti, Nunzia Capozzi, Cristina Mosconi, Francesco Modestino, Giuliano Peta, Silvia Lo Monaco, Antonio Bruno, Giulio Vara, Caterina De Benedittis, Paolo Gionchetti, Fernando Rizzello, Gilberto Poggioli ,Rita Golfieri
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11585/821702
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