Abstract
Of 117 patients who had undergone surgery for the treatment of Crohn's disease in our hospital as of March 2003, twelve patients complicated with abscess formation were studied according to the region of the abcess and causal intestine. Regarding the abscess region, there were five ventral wall cases, two pelvis cases, two iliopsoas muscle cases, one paracolitic case, and one case involving both the abdominal wall and iliopsoas muscle. Conservative treatment was performed in those cases where the abscess was localized in the ventral wall only ; surgery was performed only after reduction of the abscess. Cases involving abscess in the pelvis and/or iliopsoas muscle, on the other hand, showed resistance towards conservative treatment, and required pre-surgical puncture drainage or fecal diversion. Examination of the relevant intestinal tract found that there were eight and four cases in the right and left colon, respectively. Conservative treatment was not applicable for the left colon cases. These findings suggest that there is a need to consider the suitability of conservative treatment and surgical timing, taking into account the abscess region and causal intestine, and that conservative treatment-resistant cases require early drainage including fecal diversion.
