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Similar Long-Term Outcomes in Children Presenting With Abscess vs Phlegmon at Diagnosis of Crohn Disease
Andrew W Fondell1, Maua H Mosha1, Ross M Maltz2,3
1Division of Digestive Diseases, Hepatology, and Nutrition, Connecticut Children's, Hartford, Connecticut, USA.
Insights
Pediatric Crohn disease patients with abdominal abscess or phlegmon at diagnosis have similar high rates of surgery. This finding highlights the need for effective management strategies for these complex cases.
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease Research
Background:
- Limited long-term outcome data exist for pediatric Crohn disease patients presenting with abdominal abscess or phlegmon.
- Crohn disease diagnosis in children can involve complex abdominal presentations.
Purpose of the Study:
- To evaluate and compare the surgical management and outcomes of pediatric Crohn disease patients with abdominal abscess versus phlegmon at diagnosis.
Main Methods:
- Retrospective chart review of pediatric patients diagnosed with Crohn disease and abdominal abscess or phlegmon.
- Data collected over a 6-year period from five pediatric inflammatory bowel disease centers.
Main Results:
- 71% of 52 reviewed pediatric patients (mean age 15.9 years) with Crohn disease required surgery.
- Patients with abscess (n=36) had a 75% surgical rate, while those with phlegmon (n=16) had a 63% surgical rate.
- Surgery occurred within 6 months for 86% of patients.
Conclusions:
- Pediatric Crohn disease patients presenting with either abdominal abscess or phlegmon exhibit a similarly high rate of surgical intervention.
- The initial presentation of abscess or phlegmon does not significantly alter the high likelihood of requiring surgery in pediatric Crohn disease.
Background:
Limited data are available for long-term outcomes of pediatric patients with abdominal abscess or phlegmon at diagnosis of Crohn disease.
Methods:
We performed a retrospective chart review of such children over a recent 6-year period at 5 pediatric inflammatory bowel diseases.
Results:
Fifty-two patients (mean age 15.9 ± 1.8 years) were reviewed. Thirty-six had an abscess and 27 (75%) required resectional therapy compared to 16 with phlegmon which 10 (63%) requiring surgery. Overall (37/52) 71% had surgery which was performed within 6 months in 32 (86%).
Conclusions:
A similar high surgical rate exists whether pediatric patients with Crohn disease present with abscess or phlegmon.
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