Lambiase R E, Cronan J J, Dorfman G S, Paolella L P, Haas R A
Department of Diagnostic Radiology, Rhode Island Hospital, Brown University Program in Medicine, Providence 02902.
AJR Am J Roentgenol. 1988 May;150(5):1043-5. doi: 10.2214/ajr.150.5.1043.
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.
高达四分之一的克罗恩病患者在病程中的某些时候会出现腹部脓肿，其中大部分与肠道相通。单独经皮引流与经皮/手术联合方法或单纯手术方法相比的疗效尚未确定。我们回顾了8例克罗恩病患者9个脓肿的经皮引流结果。其中6个脓肿与肠道相通。那些与肠道相通的脓肿得到了暂时缓解，患者的医疗状况有所改善。然而，所有患者在初次引流后7周内都需要进行确定性手术。3例无肠道相通的患者经皮引流后获得了永久性治愈。我们对这个小系列病例的经验表明，克罗恩病患者中与肠道相通的脓肿可通过经皮引流得到暂时缓解。然而，使用这种技术不太可能导致长期缓解或治愈。似乎克罗恩病患者中与肠道相通的脓肿仅通过经皮治疗即可治愈。
