Strotzer M, Manke C, Lock G, Bregenzer N, Schölmerich J, Feuerbach S
Institut für Röntgendiagnostik, Universität Regensburg.
Rofo. 1998 Nov;169(5):510-4. doi: 10.1055/s-2007-1015329.
To evaluate the success of percutaneous, CT-guided abscess drainage (PAD) in patients with Crohn's disease.
Within the last 5 years 8 patients with Crohn's disease were treated by PAD for intra-abdominal abscesses. A fistula was determined to be the cause in 4 patients. The abscesses arose spontaneously in 7 patients while one patient had a postoperative abscess. We used single lumen 10 F- and double lumen 12 F- and 14 F-catheters for drainage (duration of drainage 8-20 days).
In all cases the abscess was successfully drained by PAD. However, an operation-free interval of at least three months was achieved in only two patients. A healing of the fistula was not attained in any of the 4 patients with a proven fistula. No enterocutaneous fistulas arose within the course of PAD.
PAD is also useful for patients with Crohn's disease since it improves the starting situation for the necessary operative interventions. In most cases (especially with enterogenic fistulas), however, a long-lasting therapeutic result cannot be expected.
评估经皮CT引导下脓肿引流术(PAD)治疗克罗恩病患者的成功率。
在过去5年中,8例克罗恩病患者接受了PAD治疗腹腔内脓肿。4例患者确定病因是瘘管。7例患者脓肿自发形成,1例患者为术后脓肿。我们使用单腔10F以及双腔12F和14F导管进行引流(引流持续时间8 - 20天)。
所有病例中,脓肿均通过PAD成功引流。然而,只有2例患者实现了至少三个月的无手术间隔期。4例经证实存在瘘管的患者中,无一例瘘管愈合。在PAD过程中未出现肠皮肤瘘。
PAD对克罗恩病患者也有用,因为它改善了必要手术干预的初始状况。然而,在大多数情况下(尤其是肠源性瘘管),无法预期获得持久的治疗效果。