Intra Abdominal Abscesses

Intra-abdominal abscesses can be successfully drained by an echoguided mini-invasive access like that described in regards to our patient with ulcera-tive colitis and a subhepatic abscess. In many cases, however, fistula formation and intestinal obstruction is associated with intra-abdominal abscesses, and abscess drainage does not improve the situation in the long term. More than 25% of patients undergoing surgery for Crohn's disease will have either an intraabdominal mass or abscess. Of these masses, 40% will have an associated fistula [19, 20]. Traditionally, the majority of abscesses associated with Crohn's disease have been approached with operative drainage; however, improved interventional radiological techniques have resulted in an increased use of percutaneous drainage. Doing so will facilitate an improvement in the patients general condition prior to definitive surgical repair [20]. Non-operative therapy prevented subsequent surgery in half of the patients and may be a reasonable treatment option [21]. In cases with no associated abscess primary reconstruction can be proposed.

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