Similar Long-Term Outcomes in Children Presenting With Abscess vs Phlegmon at Diagnosis of Crohn Disease. Issue 3 (20th July 2020)

• Record Type: Journal Article
• Authors: Fondell, Andrew W; Mosha, Maua H; Maltz, Ross M; Boyle, Brendan M; Niklinska-Schirtz, Barbara Joanna; Kugathasan, Subra; Gibson, Meghan E; Shapiro, Jason M; Rosenheck, Sarah M; Langseder, Annette L; Kennedy, Mary C; Rosh, Joel R; Hyams, Jeffrey S
• Is Part Of: Crohn's & colitis 360. Volume 2:Issue 3(2020)
• Publication Date: 2020-07-20
• Subjects: Crohn disease -- abscess -- children -- inflammatory bowel disease -- phlegmon; Crohn's disease -- Periodicals; Colitis -- Periodicals; 616.344
• DOI: 10.1093/crocol/otaa060
• Languages: English
• ISSNs: 2631-827X

Abstract

Abstract: Background: Limited data are available for long-term outcomes of pediatric patients with abdominal abscess or phlegmon at diagnosis of Crohn disease. Methods: We performed a retrospective chart review of such children over a recent 6-year period at 5 pediatric inflammatory bowel diseases. Results: Fifty-two patients (mean age 15.9 ± 1.8 years) were reviewed. Thirty-six had an abscess and 27 (75%) required resectional therapy compared to 16 with phlegmon which 10 (63%) requiring surgery. Overall (37/52) 71% had surgery which was performed within 6 months in 32 (86%). Conclusions: A similar high surgical rate exists whether pediatric patients with Crohn disease present with abscess or phlegmon. Lay Summary: We found the eventual need for surgery was not different in pediatric patients presenting with phlegmon vs abscess at initial diagnosis of Crohn disease. Anti-tumor necrosis factor therapy is successful in preventing surgery in a small group of these patients.