Spontaneous abdominopelvic abscess as an initial manifestation of Crohn's disease: a retrospective cohort review.

OBJECTIVE

The study aimed to compare the clinical characteristics of abdominopelvic (AP) abscess in patients with and without newly diagnosed Crohn's disease (CD).

METHODS

We investigated 91 consecutive patients with AP abscess (14 newly diagnosed with CD) from January 2001 to December 2010. The clinical, radiological, microbiological and pathological features and patients' outcomes were evaluated.

RESULTS

Patients with newly diagnosed CD were younger (42.5 vs. 57.9 years, P = 0.004), more associated with fever (50.0% vs. 13.0%, P = 0.004) and weight loss (21.4% vs. 3.9%, P = 0.045), and normoglycemic (5.2 mmol/L vs. 6.7 mmol/L, P = 0.001). Their abscesses, located predominantly at the paracolic gutter region (P = 0.002) were associated with fistulae (P = 0.001) and caused by transmural bowel wall inflammation. More patients in the CD group required temporarily parenteral nutritional support (P = 0.000) and had a longer hospital stay (P = 0.045) and a higher local recurrent rate (P = 0.000).

CONCLUSION

AP abscesses associated with newly diagnosed CD display distinct clinical behavior with a high risk of local recurrence.