Abscess and Crohn's disease – Early surgery or percutaneous drainage?

2006 ◽  
Vol 38 (9) ◽  
pp. 666-667 ◽  
Author(s):  
N.J.M. Mortensen
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Percutaneous Drainage ◽  
Early Surgery

Percutaneous Drainage of Abdominal Abscesses in Pediatric Crohn's Disease

2007 ◽  
Vol 188 (2) ◽  
pp. 579-585 ◽  
Author(s):  
Françoise Rypens ◽  
Josée Dubois ◽  
Laurent Garel ◽  
Colette Deslandres ◽  
Dickens Saint-Vil
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Percutaneous Drainage ◽  
Abdominal Abscesses

Early Surgery Versus Biologic Therapy in Limited Nonstricturing Ileocecal Crohn’s Disease—A Decision-making Analysis

2020 ◽  
Vol 26 (11) ◽  
pp. 1648-1657
Author(s):  
Efrat Broide ◽  
Adi Eindor-Abarbanel ◽  
Timna Naftali ◽  
Haim Shirin ◽  
Tzippora Shalem ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Markov Model ◽  
Treatment Strategy ◽  
Early Surgery ◽  
Published Data ◽  
Model Parameters ◽  
Decision Analysis Model ◽  
Biologic Treatment ◽  
Life Years

Abstract Background Surgery is the preferred option for patients with symptomatic localized fibrostenotic ileocecal Crohn’s disease (CD) but not for those with predominantly active inflammation without obstruction. The benefit of early surgery in patients with a limited nonstricturing ileocecal CD over biologic treatment is still a debate. Objective Our objective is to formulate a decision analysis model based on recently published data to explore whether early surgery in patients with limited nonstricturing CD is preferred over biologic treatment. Methods We constructed a Markov model comparing 2 strategies of treatment: (1) early surgery vs (2) biologic treatment. To estimate the quality-adjusted life years (QALYs) and the costs in each strategy, we simulated 10,000 virtual patients with the Markov model using a Monte Carlo simulation 100 times. Sensitivity analyses were performed to evaluate the robustness of the model and address uncertainties in the estimation of model parameters. Results The costs were $29,457 ± $407 and $50,382 ± $525 (mean ± SD) for early surgery strategy and biologic treatment strategy, respectively. The QALY was 6.24 ± 0.01 and 5.81 ± 0.01 for early surgery strategy and biologic treatment strategy, respectively. Conclusion The strategy of early surgery dominates (higher QALY value [efficacy] and less cost) compared with the strategy of biologic treatment in patients with limited ileocecal CD.

scholarly journals Crohn’s Disease Presenting with Pyogenic Liver Abscess: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Sharon McGreal ◽  
Rupert Sayers ◽  
Peter Wurm ◽  
Kevin West
Keyword(s):  
Computed Tomography ◽  
Crohn’S Disease ◽  
Case Report ◽  
Crohn's Disease ◽  
Liver Abscess ◽  
Percutaneous Drainage ◽  
Severe Disease ◽  
Pyogenic Liver Abscess ◽  
Initial Manifestation ◽  
Laboratory Findings

Pyogenic liver abscess (PLA) is a rare extraintestinal complication of Crohn’s disease (CD), and the clinical and laboratory findings may emulate the reactivation of CD, therefore, delaying diagnosis. In this paper the patient presented with PLA as the initial manifestation of CD and experienced severe disease. The finding of PLA was established by computed tomography and initial treatment involved percutaneous drainage and antibiotics. The diagnosis of CD was made after colonoscopy and histological investigations.

scholarly journals P160 Can the Lemann index at diagnosis predict the risk of early surgery in Crohn’s disease?

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S239-S239
Author(s):  
A Hassine ◽  
I Akkari ◽  
S Mrabet ◽  
E Ben Jazia
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Abdominal Surgery ◽  
Treatment Decision ◽  
Early Surgery ◽  
First Year ◽  
Rapid Disease Progression ◽  
Significant Difference ◽  
The Mean ◽  
Optimal Patient Management

Abstract Background Identifying patients with Crohn’s disease (CD) with rapid disease progression or at high risk for early surgery is a crucial pillar in the treatment decision to ensure optimal patient management. The objective of this study was to assess the correlation between the Lemann index at the time of diagnosis and abdominal surgery in the first year after diagnosis of Crohn’s disease and to find the risk factors for early surgery. Methods This is a retrospective study of all patients with CD followed in our center over a period of 4 years (January 2016- January 2020), and who were evaluated by endoscopy and MRI at baseline. The Lemann Index is a score that measures cumulative damage to digestive tissue from entero-MRI and endoscopy data. It was calculated by noting the previous surgery, the location and extension of the disease and any intestinal complications. The sociodemographic and clinical characteristics of the patients were studied. Hypothesis tests were applied to identify associations. Results 112 patients with CD were included in this study, of which 53.6% were female. The mean age at diagnosis was 33.29 years [15–63]. Active smoking was found in 34 patients (30.4%). Regarding the localization of CD, it was ileal (L1 according to the Montreal classification), colonic (L2), and ileocolonic (L3) in respectively 16.1%, 42.9% and 41%. The disease phenotype was inflammatory (B1) in 60.7%, stricturing (B2) in 21.42%, and penetrating (B3) in 17.85%. Anoperineal manifestations were noted in 24 patients. An upper digestive tract was present in 19.6% of patients. The initial flare was judged to be severe in 33.9% of cases, moderate in 55.4% of cases and mild in 10.7% of cases, with a mean CDAI of 305.21 [115–493]. During the first year after diagnosis of CD, 19.6% of patients (n = 22) required surgical treatment. The indications for surgery were: the presence of an intra-abdominal collection (27.3%), severe acute corticosteroid-resistant colitis (18.2%); ileocaecal stenosis resistant to medical treatment (27.3%) or acute bowel obstruction (27.3%). The LI at diagnosis was much higher in the early surgery group: 5.22 +/- 2.65 vs. 2.63 +/- 1.88; with a statistically significant difference (p = 0.01). A severe initial flare as well as a penetrating phenotype were predictors of early abdominal surgery (p = 0.022, p = 0.024, respectively). Conclusion According to our study, a high Lemann score at diagnosis correlates well with the risk of early surgery in Crohn’s disease. Further, larger-scale studies would be needed to establish the reliability of this test in predicting this risk.

scholarly journals Rates of Early Surgery and Associated Risk Factors in Crohn's Disease

2010 ◽  
Vol 56 (4) ◽  
pp. 236 ◽  
Author(s):  
Su Jin Jeon ◽  
Kwang Jae Lee ◽  
Myung Hee Lee ◽  
Seon Kyo Lim ◽  
Chang Jun Kang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Early Surgery ◽  
Associated Risk Factors

Lémann Index at Diagnosis Predicts the Risk of Early Surgery in Crohn’s Disease

2018 ◽  
Vol 61 (2) ◽  
pp. 207-213 ◽  
Author(s):  
Wei Liu ◽  
Wei Zhou ◽  
Jianjian Xiang ◽  
Qian Cao ◽  
Jinzhou Zhu ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Early Surgery
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