Management of intra-abdominal abscess in Crohn's disease

One of the most common complications of Crohn's disease is intra-abdominal abscesses. Intra-abdominal abscesses are associated with a penetrating phenotype of Crohn's disease and intraabdominal fistulae which develop in one-third of Crohn's disease patients. The decision-making for intra-abdominal abscesses in Crohn's disease may be complex. The literature suggests that some Crohn's disease patients with intra-abdominal abscesses may be managed non-operatively. Patients with larger abscesses and fistulae usually fail non-operative management. Percutaneous drainage and antibiotics as definitive management for intra-abdominal abscesses associated with Crohn's disease may be successful in a small number of cases, but large intra-abdominal abscesses >5 cm or abscesses associated with fistulae should have planned surgical intervention following percutaneous drainage and antibiotics.