Percutaneous drainage of abscesses in patients with Crohn disease

Up to one-quarter of patients with Crohn disease present with abdominal abscesses at some point in their illnesses, most of which have enteric communication. The efficacy of percutaneous drainage alone vs either a combined percutaneous/surgical approach or a purely surgical approach has not been established. We reviewed the results of percutaneous drainage of nine abscesses in eight patients with Crohn disease. Six of these abscesses communicated with the intestine. Those with enteric communication had temporary palliation, with improved medical status. However, all patients required definitive surgery within 7 weeks of initial drainage. Percutaneous drainage in the three patients without enteric communication resulted in a permanent cure. Our experience with this small series suggests that abscesses that have an enteric communication in patients with Crohn disease can be temporarily palliated by percutaneous drainage. However, use of this technique is unlikely to result in long-term palliation or cure. It appears that abscesses with intestinal communication in Crohn patients can be cured by percutaneous therapy alone.