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World J Gastrointest Endosc. Nov 16, 2011; 3(11): 209-212
Published online Nov 16, 2011. doi: 10.4253/wjge.v3.i11.209
Management of abdominal and pelvic abscess in Crohn’s disease
Robert J Richards
Robert J Richards, Department of Gastroenterology and Hepatology, Stony Brook University, Stony Brook, NY 11793-8173, United States
Author contributions: Richards RJ is the sole contributor.
Correspondence to: Robert J Richards, MD, MSc, Department of Gastroenterology and Hepatology, Stony Brook University, HSC Level 17, Room 063, Stony Brook, NY 11794-8173, United States. robert.richards@stonybrook.edu
Telephone: +1-631-4442119 Fax: +1-631-4448886
Received: March 18, 2011
Revised: September 7, 2011
Accepted: October 26, 2011
Published online: November 16, 2011

Patients with Crohn’s disease may develop an abdominal or pelvic abscess during the course of their illness. This process results from transmural inflammation and penetration of the bowel wall, which in turn leads to a contained perforation and subsequent abscess formation. Management of patients with Crohn’s related intra-abdominal and pelvic abscesses is challenging and requires the expertise of multiple specialties working in concert. Treatment usually consists of percutaneous abscess drainage (PAD) under guidance of computed tomography in addition to antibiotics. PAD allows for drainage of infection and avoidance of a two-stage surgical procedure in most cases. It is unclear if PAD can be considered a definitive treatment without the need for future surgery. The use of immune suppressive agents such as anti-tumor necrosis factor-α in this setting may be hazardous and their appropriate use is controversial. This article discusses the management of spontaneous abdominal and pelvic abscesses in Crohn’s disease.

Keywords: Crohn’s disease, Abdominal abscess, Psoas abscess, Abscess, Drainage, Computed tomography, Spiral, Infection, Colorectal surgery