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Updated: Mar 20, 2026
Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
Outcomes of early ileocolectomy after percutaneous drainage for perforated ileocolic Crohn's disease
William Sangster1, Arthur S Berg2, Christine S Choi1
1Department of Surgery, The Pennsylvania State University, College of Medicine, 500 University Drive, Hershey, PA 17033-0850, USA.
Insights
Optimal treatment for perforating ileocolic Crohn's disease (PCD) with abscess is unclear. Early surgery after drainage may increase ileostomy and readmission rates in PCD patients compared to elective surgery.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Inflammatory Bowel Disease Research
Background:
- Optimal management for intra-abdominal abscess secondary to perforating ileocolic Crohn's disease (PCD) remains undefined.
- Current treatment strategies lack clear consensus, necessitating further investigation.
Purpose of the Study:
- To compare outcomes of ileocolectomy following percutaneous drainage in PCD patients versus elective ileocolectomy for Crohn's disease (ECD).
- To evaluate the impact of early operative intervention on patient outcomes in PCD.
Main Methods:
- Retrospective comparison of 47 PCD patients (ileocolectomy after percutaneous drainage) and 160 ECD patients (elective ileocolectomy) from 1992-2014.
- Univariate analysis and propensity score matching were employed to compare outcomes.
Main Results:
- PCD patients had significantly higher ileostomy rates (48.9% vs 18.8%) and 30-day readmissions (38.3% vs 18.8%) compared to ECD patients.
- These differences, including overall 30-day postoperative complications (29.8% vs 15%), remained significant after propensity score matching.
Conclusions:
- Early surgical intervention after percutaneous drainage for PCD is associated with increased rates of ostomy diversions and hospital readmissions.
- These findings suggest a potential need to reconsider the timing of surgical intervention in PCD management.
Background:
The optimal treatment for an intra-abdominal abscess/infection secondary to perforating ileocolic Crohn's disease (PCD) is unclear.
Methods:
Forty-seven consecutive PCD patients treated via an institutional protocol of ileocolectomy after a 7-day period of percutaneous abscess drainage were retrospectively compared with 160 consecutive patients who underwent an elective ileocolectomy for Crohn's disease (ECD) between 1992 and 2014. Outcomes were compared using univariate analysis and propensity score matching.
Results:
Univariate analysis demonstrated significant differences in ileostomy rates (PCD: 48.9% vs ECD: 18.8%; P = .001), 30-day readmissions (PCD: 38.3% vs ECD: 18.8%; P = .01), and overall 30-day postoperative complications (PCD: 29.8% vs ECD: 15%; P = .03). After matching, a statistically significant difference was retained in ileostomy rates (P = .02) and 30-day readmissions (P = .01).
Conclusions:
Early operative intervention after percutaneous drainage in perforating CD may be associated with a high incidence of diversions and readmissions.
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