Percutaneous Drainage of Abdominal Abscesses in Pediatric Crohn's Disease
| Autor: | Colette Deslandres, Laurent Garel, Dickens Saint-Vil, Josée Dubois, Françoise Rypens |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
Male
medicine.medical_specialty Abdominal Abscess Percutaneous Adolescent Crohn Disease medicine Humans Radiology Nuclear Medicine and imaging Child Abscess Crohn's disease business.industry Retrospective cohort study General Medicine medicine.disease Infliximab Surgery Clinical trial Treatment Outcome Surgery Computer-Assisted El Niño Drainage Female Radiology business medicine.drug |
| Zdroj: | American Journal of Roentgenology. 188:579-585 |
| ISSN: | 1546-3141 0361-803X |
| DOI: | 10.2214/ajr.06.0181 |
| Popis: | Crohn's disease is complicated by abscesses in 10-30% of patients during their lifetime. The goal of our study was to illustrate that, besides surgical treatment, percutaneous abscess drainage plays a major role in treating children with Crohn's disease.This retrospective study included 14 pediatric patients (age range, 12-17 years; median age, 15 years) with proven Crohn's disease. Percutaneous abscess drainage was performed for 15 abdominal or pelvic abscesses or for both abdominal and pelvic abscesses. The abscess was an initial manifestation of Crohn's disease in four patients and complicated well-known disease in 10 patients. Abscesses occurred spontaneously (n = 11), after surgery (n = 3), or after infliximab treatment (n = 1). Their volume ranged from 8 to 442 mL (mean, 113 mL). Fistulas with the bowel were detected in eight cases.Sixteen percutaneous abscess drainages were performed under sonographic or CT guidance (or both) using 6- or 8-French catheters. The procedure was performed with the patient under conscious sedation (n = 14) or anesthesia (n = 2). The duration of the drainage was 1-30 days (mean, 11 days). An enterocutaneous fistula, medically treated with success, was the only complication observed. Complete resolution of the collection was observed in eight abscesses and partial resolution in seven. Resection of the diseased bowel segment with primary anastomosis was possible in 12 patients. In two patients, percutaneous abscess drainage was not followed by surgery.Percutaneous abscess drainage is a valuable procedure in pediatric patients with Crohn's disease presenting with pelvic or abdominal abscesses (or both). It improves the general status of the patient and allows a less invasive and easier subsequent surgical procedure. Percutaneous abscess drainage should be performed before definitive treatment. |
| Databáze: | OpenAIRE |
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