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Abstract

Background - Percutaneous abscess drainage is the first-line approach for abscess in Crohn’s disease since it procrastinates/avoids surgery especially in postoperative abscesses (within 30 days) Objective - We retrospectively evaluated the effectiveness, complications and outcome after percutaneous abscess drainage in postoperative and spontaneous abscesses and factors influencing the outcomes. Design – A population with abscess of Crohn’s disease Settings - This study was conducted within the Department of Diagnostic and Interventional Radiology Unit of Bologna Patients - We performed percutaneous abscess drainage in 91 abscesses, 45 (49,5%) postoperative and 46 (50,5%) spontaneous. Main outcome measures - We defined the overall success as clinical and technical success 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 technical success but patients with a residual intraoperative abscess were considered Overall technical success was overall success plus technical success. Complications were classified as major and minor according to the Interventional Radiology Criteria.   Results - In postoperative abscesses we found 91% overall success, 9% technical success, no Technical failure and 100% Overall technical success. In spontaneous abscesses we found 33% overall success, 63% technical success, 4% Technical failure, 95,6% Overall technical success. A total abscess resolution was achieved in 97,8% of patients. No major complication occurred; only 1 case of minor complication. Factors statistically influencing the outcome were postoperative vs spontaneous collections (91% vs 32%) (p<0.0001), multiloculated vs uniloculated collections (38% vs 1%) (p<0.0001) and upper abdominal vs lower location (13% vs 25%) (p<0.005). Limitations - Retrospective study Conclusions - Our data confirms the safety and effectiveness of Percutaneous abscess drainage even in cases needing surgery within 30 days; most remarkable, it allows avoidance of early reoperation in almost all the patients with postoperative abscess.

Authors

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

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