Evaluation of Long-Term Outcomes of Crohn’s Disease Complicated by Intra-Abdominal Abscess: A Retrospective International Cohort Study

Bacsur P., Nemeczek S., Filip R., Fousekis F., Mpakogiannis K., Kagramanova A., ...Daha Fazla

Journal of Clinical Medicine, cilt.15, sa.7, 2026 (SCI-Expanded, Scopus) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 15 Sayı: 7
  • Basım Tarihi: 2026
  • Doi Numarası: 10.3390/jcm15072724
  • Dergi Adı: Journal of Clinical Medicine
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE
  • Anahtar Kelimeler: abdominal abscess, Crohn’s disease, penetrating disease, percutaneous drainage, surgery
  • Ankara Üniversitesi Adresli: Evet

Özet

Background: Crohn’s disease complicated by intra-abdominal abscesses often requires surgery. Percutaneous drainage may prevent surgery, but optimal post-drainage management is unclear. We aimed to analyze the long-term outcomes of Crohn’s disease with intra-abdominal abscesses after intervention. Methods: Patients with penetrating Crohn’s disease and a single intra-abdominal abscess were enrolled in this multicenter, international, retrospective study after the detection of the abscess (baseline), with a minimum follow-up of 12 months. Those requiring urgent bowel resection were excluded. Patients were grouped by elective surgical need after successful (catheter insertion with effective drainage) percutaneous drainage (controls: no pre-resection drainage). The primary outcome was abscess recurrence. We also assessed stoma rate, post-procedural complications, hospitalizations, advanced treatment need, postoperative luminal recurrence, and need for re-drainage. Results: We studied 157 patients with Crohn’s disease (9 countries; males: 58%, median age: 32.4 [interquartile range: 25–39 years]); 89/157 underwent percutaneous drainage (median follow-up: 95.9 weeks [interquartile range: 58–104]). Abscess recurrence did not differ by drainage (p = 0.221). Abscess size was associated with advanced-treatment initiation (Odds ratio: 0.978; 95% confidence interval: 0.960–0.997, p = 0.023) and postoperative luminal recurrence (Odds ratio: 1.044, 95% confidence interval: 1.012–1.078, p = 0.007). Time to resection was longer after drainage, and ROC analysis raised predictive value for re-drainage (16.6 weeks post-drainage; AUC = 0.82, 95% confidence interval: 0.73–0.92). Patients without drainage had more post-procedural complications. Conclusions: Abscess size should guide management. Delayed resection may increase re-drainage odds, whereas surgery alone may have higher complication rates. Percutaneous drainage can safely postpone resection.