Jawhari A, Kamm M A, Ong C, Forbes A, Bartram C I, Hawley P R
Department of Surgery, St. Mark's Hospital, Northwick Park, Harrow, UK.
Br J Surg. 1998 Mar;85(3):367-71. doi: 10.1046/j.1365-2168.1998.00575.x.
Intra-abdominal and pelvic abscesses occur in 10-30 per cent of patients with Crohn's disease. The aim of this study was to establish the clinical characteristics and outcome of patients admitted over a 4-year period with an abdominal or pelvic abscess secondary to Crohn's disease.
Patients with Crohn's disease-related intra-abdominal or pelvic abscess were identified from a prospectively collected database, comprising all admissions between 1991 and 1994. Medical records were reviewed retrospectively and data gathered regarding management and outcome.
Thirty-six patients were identified with Crohn's disease-related abscess, of whom 15 were considered for initial percutaneous drainage. Drainage was technically possible in eight of these patients: it failed in four, gave good long-term results in two, and was followed by recurrence after 3 years in one and by later surgery unrelated to the abscess in one. Twenty-eight patients underwent surgery, with only four requiring a stoma. Complications occurred in 12 patients. At 3 months, 22 of the 36 patients were in remission.
Crohn's intra-abdominal abscesses are associated with a high morbidity rate. Selected cases can be drained percutaneously, without adding to the morbidity, and sometimes resulting in abscess resolution.
腹腔和盆腔脓肿发生于10% - 30%的克罗恩病患者中。本研究的目的是确定4年间因克罗恩病继发腹腔或盆腔脓肿而入院患者的临床特征及预后。
从一个前瞻性收集的数据库中识别出患有克罗恩病相关腹腔或盆腔脓肿的患者，该数据库包含1991年至1994年间的所有入院病例。对病历进行回顾性审查，并收集有关治疗和预后的数据。
确定了36例患有克罗恩病相关脓肿的患者，其中15例考虑进行初始经皮引流。这些患者中有8例在技术上可行引流：4例失败，2例取得良好的长期效果，1例在3年后复发，1例后来接受了与脓肿无关的手术。28例患者接受了手术，仅4例需要造口。12例患者出现并发症。3个月时，36例患者中有22例缓解。
克罗恩病腹腔脓肿的发病率较高。部分病例可经皮引流，不会增加发病率，有时可使脓肿消退。
