HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Rypens, F. Articles by Saint-Vil, D. Search for Related Content PubMed PubMed Citation Articles by Rypens, F. Articles by Saint-Vil, D. Social Bookmarking                      What's this? Hotlight (NEW!) What's Hotlight?

Percutaneous Drainage of Abdominal Abscesses in Pediatric Crohn's Disease

¹ Department of Medical Imaging, Sainte-Justine Mother-Child University Hospital, 3175 Cote Sainte-Catherine Rd., Montreal, QC H3T 1C5, Canada.
² Department of Pediatrics, Division of Gastroenterology, Sainte-Justine Mother-Child University Hospital, Montreal, QC H3T 1C5, Canada.
³ Department of Surgery, Sainte-Justine Mother-Child University Hospital, Montreal, QC H3T 1C5, Canada.

OBJECTIVE. 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.

MATERIALS AND METHODS. 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.

RESULTS. 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.

CONCLUSION. 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.

Keywords: abdominal imaging • abscess drainage • Crohn's disease • pediatric imaging • percutaneous drainage

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?