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Digestive Diseases (Basel, Switzerland) 2014Crohn's disease (CD) is characterized by full-thickness inflammation of the bowel. For this reason, perforating complications such as intra-abdominal abscesses or... (Review)
Review
Crohn's disease (CD) is characterized by full-thickness inflammation of the bowel. For this reason, perforating complications such as intra-abdominal abscesses or fistulas are common. A concomitant intra-abdominal abscess with active CD of the small bowel is a challenging dilemma for gastroenterologists and surgeons. Since there is active and severe disease, this should be treated with immunosuppressive drugs. However, in the presence of an intra-abdominal abscess, immunosuppression can be dangerous. There are several treatment options for intra-abdominal abscesses in CD. Nowadays, the first-line treatment is antibiotic therapy with or without percutaneous drainage. Historically, patients were treated with surgical drainage. With the development of percutaneous drainage, treatment shifted to a more nonsurgical approach. Success rates for percutaneous drainage in the literature vary from 74 to 100%, and it is considered to be a relatively safe procedure. It has been reported that surgery can be avoided after successful percutaneous drainage in a variable number of patients (14-85%). If sepsis is controlled, CD medication should be started to prevent recurrence. It is important to monitor the effect upon CD lesions to avoid further perforating complications. Finally, an undrainable or small abscess can be treated with antibiotics alone, although high recurrence rates have been described with this approach. Patients with a concomitant stenosis, an enterocutaneous fistula or refractory active disease are likely to require surgery. Percutaneous drainage in combination with delayed surgery is useful to improve the patient's condition prior to surgery and is associated with less morbidity, a lower stoma rate and more limited resection. In conclusion, when feasible, percutaneous drainage and antibiotics should be the treatment of choice in patients with an intra-abdominal abscess in CD. If surgery is inevitable, this must be delayed to reduce postoperative septic complications and high stoma rates.
Topics: Abdominal Abscess; Anti-Inflammatory Agents; Crohn Disease; Drainage; Humans; Postoperative Period; Recurrence
PubMed: 25531361
DOI: 10.1159/000367859 -
Jornal Brasileiro de Nefrologia 2022
Topics: Abdominal Abscess; Humans; Peritoneal Dialysis; Peritonitis
PubMed: 34874986
DOI: 10.1590/2175-8239-JBN-2021-0131 -
Diseases of the Colon and Rectum Mar 2023
Topics: Humans; Abdominal Abscess; Anti-Bacterial Agents; Drainage
PubMed: 36395429
DOI: 10.1097/DCR.0000000000002676 -
Radiologic Technology 2015Intra-abdominal abscesses arise from complications of surgery and disease. Computed tomography (CT) facilitates abscess drainage procedures while reducing the risks and... (Review)
Review
Intra-abdominal abscesses arise from complications of surgery and disease. Computed tomography (CT) facilitates abscess drainage procedures while reducing the risks and costs associated with surgery. These procedures require collaboration to ensure positive patient outcomes. To perform their role in CT-guided intra-abdominal abscess drainage, radiologic technologists must understand patient care, instrumentation, imaging techniques, and underlying disease processes specific to the anatomical site. Once these considerations are grasped, CT technologists can help radiologists and administrators to determine cost-effective instrumentation and quality control specific to the patient and institution.
Topics: Abdominal Abscess; Drainage; Humans; Radiography, Abdominal; Surgery, Computer-Assisted; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 26538228
DOI: No ID Found -
Gastroenterology Clinics of North... Jun 2021Intra-abdominal and anorectal abscesses are common pathologies seen in both inpatient and outpatient settings. To decrease morbidity and mortality, early diagnosis and... (Review)
Review
Intra-abdominal and anorectal abscesses are common pathologies seen in both inpatient and outpatient settings. To decrease morbidity and mortality, early diagnosis and treatment are essential. After adequate drainage via a percutaneous or incisional approach, patients need to be monitored for worsening symptoms or recurrence and evaluated for the underlying condition that may have contributed to abscess formation.
Topics: Abdominal Abscess; Abscess; Crohn Disease; Drainage; Humans; Recurrence; Retrospective Studies
PubMed: 34024453
DOI: 10.1016/j.gtc.2021.02.014 -
Der Chirurg; Zeitschrift Fur Alle... Aug 1998In more than 80% of cases, intra-abdominal abscesses derive from an intra-abdominal organ, and in most cases they develop after operative procedures. Regarding anatomy,... (Review)
Review
In more than 80% of cases, intra-abdominal abscesses derive from an intra-abdominal organ, and in most cases they develop after operative procedures. Regarding anatomy, intra-abdominal abscesses can be divided into intra-peritoneal and visceral abscesses and those located in the anterior retroperitoneal space. Despite improvements in ultrasonography, CT is still the most effective method in diagnosis and therapy. Percutaneous ultrasound or CT-guided drainage is a therapy characterized by low procedural morbidity and is successful in 80% of cases if strict criteria are met. Complicated abscesses and those cases in which the underlying disease has to be treated require surgical intervention. Most liver abscesses are treated interventionally; in abscesses of the pancreas or spleen and in Crohn's disease, surgery is necessary. The combination with sufficient antibiotic drug therapy is very important. Specific infectious diseases appearing as intra-abdominal conglomerates (tuberculosis, actinomycosis, amebiasis) lead to a delay in diagnostics because of their scarcity and are characterized by special patho-anatomical, diagnostic and therapeutic features. The crucial thing is to take a specific infection into consideration.
Topics: Abdominal Abscess; Drainage; Humans; Tomography, X-Ray Computed; Ultrasonography
PubMed: 9782397
DOI: 10.1007/s001040050495 -
The British Journal of Surgery May 2003Intra-abdominal adhesions and abscesses cause significant morbidity and mortality. The formation of fibrin in the abdominal cavity is a common pathophysiological pathway... (Review)
Review
BACKGROUND
Intra-abdominal adhesions and abscesses cause significant morbidity and mortality. The formation of fibrin in the abdominal cavity is a common pathophysiological pathway for both. The aim of this review was to investigate the pathophysiology of intra-abdominal adhesions and abscesses, and to explore the possible sites of action of hyaluronan.
METHODS
Data were reviewed from the literature using the Medline database.
RESULTS
Both surgery and peritonitis disturb the equilibrium between coagulation and fibrinolysis in the abdominal cavity in favour of the coagulation system. Hyaluronan-based agents reduce adhesion formation after surgery. Moreover, hyaluronan solution reduces abscess formation in experimental peritonitis. Possible mechanisms of action include mechanical separation of wound surfaces, improvement of peritoneal healing, modulation of the inflammatory response and enhanced fibrinolysis.
CONCLUSION
Diminished fibrin degradation is a common pathway for the formation of adhesions and abscesses. The potential of hyaluronan-based agents to reduce intra-abdominal adhesions and abscesses in abdominal surgery and sepsis is a promising new concept. Elucidating the mechanisms involved and the clinical application of hyaluronan in peritonitis are challenges for future research.
Topics: Abdominal Abscess; Adjuvants, Immunologic; Humans; Hyaluronic Acid; Tissue Adhesions
PubMed: 12734857
DOI: 10.1002/bjs.4141 -
Asian Journal of Surgery Jun 2023
Topics: Female; Humans; Liver Abscess; Abdominal Abscess; Abdomen
PubMed: 36610906
DOI: 10.1016/j.asjsur.2022.12.099 -
ANZ Journal of Surgery Oct 2020
Topics: Abdominal Abscess; Appendectomy; Drainage; Humans
PubMed: 33710733
DOI: 10.1111/ans.16134 -
Clinical Journal of Gastroenterology Apr 2021We report a rare case of amebiasis associated with an intraabdominal abscess without colitis, an intestinal perforation, or other extraintestinal amebiasis. A patient...
We report a rare case of amebiasis associated with an intraabdominal abscess without colitis, an intestinal perforation, or other extraintestinal amebiasis. A patient was admitted with cirrhosis and a history of spontaneous bacterial peritonitis (SBP) and was found to have a high C-reactive protein (CRP) level. Dynamic CT and ultrasound echo findings showed an intraabdominal abscess. No intestinal lesions or extraintestinal lesions other than the intraabdominal abscess were observed. Blood cultures and puncture fluid cultures were negative for bacteria. However, microscopic examination of the puncture fluid showed a cystic form of amoeba, leading to a diagnosis of an amoeba abscess. The abscess disappeared after 10 days of oral treatment with metronidazole. When an abdominal abscess is seen in an immunocompromised patient such as a cirrhotic patient, amoeba infection should be considered as a possible diagnosis.
Topics: Abdominal Abscess; Amoeba; Entamoeba histolytica; Entamoebiasis; Humans; Liver Abscess, Amebic; Metronidazole
PubMed: 33428067
DOI: 10.1007/s12328-020-01331-0