PERCUTANEOUS DRAINAGE OF INTRAABDOMINAL ABSCESSES IN CROHNS-DISEASE -SHORT AND LONG-TERM OUTCOME

Objective: To determine whether percutaneous drainage of Crohn's absce sses obviates the need for early surgical drainage, Methods: All cases of percutaneous drainage of Crohn's abscesses between 1990 and 1995 w ere reviewed and classified as a success or failure on the basis of th e need for surgery within <30 days of catheter removal. Results: Twent y-seven drainage procedures were performed in 24 patients; 15 (56%) we re classified as successes, and 12 (44%) were classified as failures, Successes and failures did not significantly differ with respect to pa tient demographics and Crohn's disease characteristics. Patients whose abscesses were successfully drained had significantly fewer associate d fistulae (46.6 vs 92.0%, p = 0.037), and their abscesses tended more often to be first (vs recurrent), spontaneous (vs postoperative), loc ated in the right lower quadrant, and smaller. Patients whose abscesse s were successfully drained also tended to spend more time with the ca theter in place and to require more imaging procedures, Complications were noted in four cases (15%), enterocutaneous fistula at the site of catheter insertion in three cases and postprocedure fever in one case , Hospital stay was significantly shorter after successful drainage (1 6.3 +/- 6.9 vs 31.7 +/- 22.1 days, p = 0.017), After a total of 543.5 patient-months of follow-up, subsequent intra-abdominal Crohn's-relate d surgery was required in only two of the successes and one failure, C onclusions: 1) Percutaneous drainage of Crohn's abscess successfully o bviates the need for early surgery in approximately 50% of cases, and this benefit is maintained on long term follow-up, 2) Percutaneous dra inage shortens hospital stay, 3) Crohn's abscesses in various location s, single or multiple, with or without an associated fistula may be su ccessfully drained percutaneously, 4) Presence of an associated fistul a may be a risk factor for failure.