Clinical efficacy of nonsurgical treatment of Crohn's disease-related intraabdominal abscess

BACKGROUND/AIMS: This study was conducted to compare the clinical efficacy between surgical and nonsurgical treatments for patients with Crohn's disease-related intraabdominal abscess. METHODS: A retrospective review of medical records was performed for patients admitted to a single institution due to Crohn's disease-related intraabdominal abscess from February, 1996 to February, 2008. Clinical outcomes were compared between surgical and nonsurgical groups in terms of treatment responses and recurrences. RESULTS: A total of 47 episodes of intraabdominal abscesses in 43 patients (12.7%) were identified from 339 patients with Crohn's disease. Of these, initially, 18 cases (38.3%) underwent surgical treatment and 29 (61.7%) were treated medically (antibiotic treatments with or without percutaneous drainage). The overall treatment response rates of surgical and nonsurgical group were 100% versus 89.7% (p=0.11) and recurrence rates were 27.8% versus 30.8% (p=1.00). Three patients in nonsurgical group (10.3%) showed no response to therapy and ultimately received surgical drainages. The median length of hospitalization in nonsurgical group was shorter than in surgical group (12 and 29.5 days, respectively. p=0.02). CONCLUSIONS: Nonsurgical treatment might be as effective as surgical treatment for the treatment of Crohn's disease-related intraabdominal abscess, especially considering shorter hospital stay.