DIAGNOSIS AND TREATMENT OF INFLAMMATORY I NFILTRATES IN THE ABDOMINAL-CAVITY IN CROHNS-DISEASE

An infiltrate in the abdominal cavity in Crohn's disease does not hind er successful drug therapy in most cases. A positive effect (regressio n or a marked decrease in the size of the infiltrate) is achieved in 8 0% of patients, mostly in those with a moderately or mildly severe for m of the disease in which a sufficiently prolonged, 10-12-week course of antiinflammatory treatment can be conducted. Combination of prednis olone with azathioprine and antibiotics is most justified. The prednis olone dose is determined by the severity and activity of the disease r ather than by the infiltrate. Antibiotics are necessary only in high f ever and treatment with them may be limited to 10-14 days in the absen ce of septicemia. Interrupted seasonal courses of sulfasalazine therap y may fail to prevent exacerbation and, consequently, recurrent infilt rates. These respond readily to repeated drug therapy and do not expan d the indications for surgery. Operations were performed on 14 patient s, in 11 of them the infiltrate did not recur again.