000136332 001__ 136332
000136332 005__ 20250923084426.0
000136332 0247_ $$2doi$$a10.1093/ecco-jcc/jjad184
000136332 0248_ $$2sideral$$a139315
000136332 037__ $$aART-2024-139315
000136332 041__ $$aeng
000136332 100__ $$0(orcid)0000-0001-6883-8940$$aCasas Deza, Diego$$uUniversidad de Zaragoza
000136332 245__ $$aInitial Management of Intra-abdominal Abscesses and Preventive Strategies for Abscess Recurrence in Penetrating Crohn’s Disease: A National, Multicentre Study Based on ENEIDA Registry
000136332 260__ $$c2024
000136332 5203_ $$aIntroduction
Intra-abdominal abscesses complicating Crohn’s disease [CD] are a challenging situation. Their management, during hospitalisation and after resolution, is still unclear.
Methods
Adult patients with CD complicated with intra-abdominal abscess. who required hospitalisation, were included from the prospectively maintained ENEIDA registry from GETECCU. Initial strategy effectiveness and safety to resolve abscess was assessed. Survival analysis was performed to evaluate recurrence risk. Predictive factors associated with resolution were evaluated by multivariate regression and predictive factors associated with recurrence were assessed by Cox regression.
Results
In all, 520 patients from 37 Spanish hospitals were included; 322 [63%] were initially treated with antibiotics alone, 128 [26%] with percutaneous drainage, and 54 [17%] with surgical drainage. The size of the abscess was critical to the effectiveness of each treatment. In abscesses < 30 mm, the antibiotic was as effective as percutaneous or surgical drainage. However, in larger abscesses, percutaneous or surgical drainage was superior. In abscesses > 50 mm, surgery was superior to percutaneous drainage, although it was associated with a higher complication rate. After abscess resolution, luminal resection was associated with a lower 1-year abscess recurrence risk [HR 0.43, 95% CI 0.24-0.76]. However, those patients who initiated anti-TNF therapy had a similar recurrence risk whether luminal resection had been performed.
Conclusions
Small abscesses [<30mm] can be managed with antibiotics alone; larger ones require drainage. Percutaneous drainage will be effective and safer than surgery in many cases. After discharge, anti-TNF therapy reduces abscess recurrence risk in a similar way to bowel resection.
000136332 536__ $$9info:eu-repo/grantAgreement/ES/ISCIII-FEDER/CM21-00067
000136332 540__ $$9info:eu-repo/semantics/openAccess$$aAll rights reserved$$uhttp://www.europeana.eu/rights/rr-f/
000136332 590__ $$a8.7$$b2024
000136332 592__ $$a2.991$$b2024
000136332 591__ $$aGASTROENTEROLOGY & HEPATOLOGY$$b12 / 147 = 0.082$$c2024$$dQ1$$eT1
000136332 593__ $$aMedicine (miscellaneous)$$c2024$$dQ1
000136332 593__ $$aGastroenterology$$c2024$$dQ1
000136332 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000136332 700__ $$aPolo Cuadro, Cristina
000136332 700__ $$ade Francisco, Ruth
000136332 700__ $$aVela González, Milagros
000136332 700__ $$aBermejo, Fernando
000136332 700__ $$aBlanco, Ignacio
000136332 700__ $$ade la Serna, Álvaro
000136332 700__ $$aBujanda, Luis
000136332 700__ $$aBernal, Lorena
000136332 700__ $$aRueda García, José Luis
000136332 700__ $$0(orcid)0000-0002-3545-2707$$aGargallo-Puyuelo, Carla J$$uUniversidad de Zaragoza
000136332 700__ $$aFuentes-Valenzuela, Esteban
000136332 700__ $$aCastro, Beatriz
000136332 700__ $$aGuardiola, Jordi
000136332 700__ $$aLadrón, Gemma
000136332 700__ $$aSuria, Carles
000136332 700__ $$aSáez Fuster, Julia
000136332 700__ $$aGisbert, Javier P
000136332 700__ $$aSicilia, Beatriz
000136332 700__ $$aGomez, Raquel
000136332 700__ $$aMuñoz Vilafranca, Carmen
000136332 700__ $$aBarreiro-De Acosta, Manuel
000136332 700__ $$aPeña, Elena
000136332 700__ $$aCastillo Pradillo, Marta
000136332 700__ $$aCerrillo, Elena
000136332 700__ $$aCalvet, Xavier
000136332 700__ $$aManceñido, Noemí
000136332 700__ $$aMonfort i Miquel, David
000136332 700__ $$aMarín, Sandra
000136332 700__ $$aRoig, Cristina
000136332 700__ $$aMarce, Ainhoa
000136332 700__ $$aRamírez de Piscina, Patricia
000136332 700__ $$aBetoré, Elena
000136332 700__ $$aMartin-Cardona, Albert
000136332 700__ $$aTeller, Marta
000136332 700__ $$aAlonso Abreu, Inmaculada
000136332 700__ $$aMaroto, Nuria
000136332 700__ $$aFrago, Santiago
000136332 700__ $$aGardeazabal, Diego
000136332 700__ $$aPérez-Martínez, Isabel
000136332 700__ $$aFebles González, Ángel David
000136332 700__ $$aBarrero, Sara
000136332 700__ $$aTaxonera, Carlos
000136332 700__ $$aGarcía de la Filia, Irene
000136332 700__ $$aEzkurra-Altuna, Ander
000136332 700__ $$aMadero, Lucía
000136332 700__ $$aMartín-Arranz, María Dolores
000136332 700__ $$0(orcid)0000-0003-0076-3529$$aGomollón, Fernando$$uUniversidad de Zaragoza
000136332 700__ $$aDomènech, Eugeni
000136332 700__ $$0(orcid)0000-0003-3970-5457$$aGarcía-López, Santiago$$uUniversidad de Zaragoza
000136332 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000136332 773__ $$g18, 4 (2024), 578-588$$pJ. Crohns  Colitis$$tJournal of Crohn's & colitis$$x1873-9946
000136332 8564_ $$s366975$$uhttps://zaguan.unizar.es/record/136332/files/texto_completo.pdf$$yVersión publicada
000136332 8564_ $$s2816875$$uhttps://zaguan.unizar.es/record/136332/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000136332 909CO $$ooai:zaguan.unizar.es:136332$$particulos$$pdriver
000136332 951__ $$a2025-09-22-14:39:52
000136332 980__ $$aARTICLE