Computerized tomography features acting as predictors for invasive therapy in the management of Crohn’s disease-related spontaneous intra-abdominal abscess: experience from long-term follow-up
Abstract Background Decision-making in the management of Crohn’s disease (CD)-related spontaneous intra-abdominal abscess (IAA) is challenging. This study aims to reveal predictive factors for percutaneous drainage and/or surgery in the treatment of CD-related spontaneous IAA through long-term follo...
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BMC
2024-11-01
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| Series: | BMC Medical Imaging |
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| Online Access: | https://doi.org/10.1186/s12880-024-01475-2 |
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| author | Yinghao Sun Wei Liu Ye Ma Hong Yang Yue Li Bei Tan Ji Li Jiaming Qian |
| author_facet | Yinghao Sun Wei Liu Ye Ma Hong Yang Yue Li Bei Tan Ji Li Jiaming Qian |
| author_sort | Yinghao Sun |
| collection | DOAJ |
| description | Abstract Background Decision-making in the management of Crohn’s disease (CD)-related spontaneous intra-abdominal abscess (IAA) is challenging. This study aims to reveal predictive factors for percutaneous drainage and/or surgery in the treatment of CD-related spontaneous IAA through long-term follow-up. Methods Data were collected, including clinical manifestations, radiography and treatment strategies, in Chinese patients with CD-related IAA in a tertiary medical center. Univariate and Multivariate Cox analysis were conducted to identify predictors for invasive therapy. Results Altogether, 48 CD patients were identified as having IAA through enhanced CT scans. The median follow-up time was 45.0 (23.3, 58.0) months. 23 (47.9%) patients underwent conservative medical treatment, and 25 (52.1%) patients underwent percutaneous drainage and/or surgical intervention (invasive treatment group). The 1-, 2-, and 5-year overall survival rates without invasive treatment were 75.0%, 56.1%, and 46.1%, respectively. On univariate Cox analysis, the computerized tomography (CT) features including nonperienteric abscess (HR: 4.22, 95% CI: 1.81–9.86, p = 0.001), max abscess diameter (HR: 1.01, 95% CI: 1.00-1.02, p<0.001) and width of sinus (HR: 1.27, 95% CI: 1.10–1.46, p = 0.001) were significantly associated with invasive treatment. Nonperienteric abscess was significantly associated with invasive treatment on multivariate Cox analysis (HR: 3.11, 95% CI: 1.25–7.71, p = 0.015). A score model was built by width of sinus, location of abscess and max abscess diameter to predict invasive treatment. The AUC of ROC, sensitivity and specificity were 0.892, 80.0% and 90.9% respectively. Conclusions More than half of CD-related IAA patients needed invasive therapy within 5-year follow-up. The CT features including nonperienteric abscess, larger maximum abscess diameter and width of sinus suggested a more aggressive approach to invasive treatment. |
| format | Article |
| id | doaj-art-e7dee85727c04f7b864548aaac72747c |
| institution | OA Journals |
| issn | 1471-2342 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Imaging |
| spelling | doaj-art-e7dee85727c04f7b864548aaac72747c2025-08-20T02:13:32ZengBMCBMC Medical Imaging1471-23422024-11-012411910.1186/s12880-024-01475-2Computerized tomography features acting as predictors for invasive therapy in the management of Crohn’s disease-related spontaneous intra-abdominal abscess: experience from long-term follow-upYinghao Sun0Wei Liu1Ye Ma2Hong Yang3Yue Li4Bei Tan5Ji Li6Jiaming Qian7Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeAbstract Background Decision-making in the management of Crohn’s disease (CD)-related spontaneous intra-abdominal abscess (IAA) is challenging. This study aims to reveal predictive factors for percutaneous drainage and/or surgery in the treatment of CD-related spontaneous IAA through long-term follow-up. Methods Data were collected, including clinical manifestations, radiography and treatment strategies, in Chinese patients with CD-related IAA in a tertiary medical center. Univariate and Multivariate Cox analysis were conducted to identify predictors for invasive therapy. Results Altogether, 48 CD patients were identified as having IAA through enhanced CT scans. The median follow-up time was 45.0 (23.3, 58.0) months. 23 (47.9%) patients underwent conservative medical treatment, and 25 (52.1%) patients underwent percutaneous drainage and/or surgical intervention (invasive treatment group). The 1-, 2-, and 5-year overall survival rates without invasive treatment were 75.0%, 56.1%, and 46.1%, respectively. On univariate Cox analysis, the computerized tomography (CT) features including nonperienteric abscess (HR: 4.22, 95% CI: 1.81–9.86, p = 0.001), max abscess diameter (HR: 1.01, 95% CI: 1.00-1.02, p<0.001) and width of sinus (HR: 1.27, 95% CI: 1.10–1.46, p = 0.001) were significantly associated with invasive treatment. Nonperienteric abscess was significantly associated with invasive treatment on multivariate Cox analysis (HR: 3.11, 95% CI: 1.25–7.71, p = 0.015). A score model was built by width of sinus, location of abscess and max abscess diameter to predict invasive treatment. The AUC of ROC, sensitivity and specificity were 0.892, 80.0% and 90.9% respectively. Conclusions More than half of CD-related IAA patients needed invasive therapy within 5-year follow-up. The CT features including nonperienteric abscess, larger maximum abscess diameter and width of sinus suggested a more aggressive approach to invasive treatment.https://doi.org/10.1186/s12880-024-01475-2Crohn’s diseaseSpontaneous intra-abdominal abscessPercutaneous drainageSurgery |
| spellingShingle | Yinghao Sun Wei Liu Ye Ma Hong Yang Yue Li Bei Tan Ji Li Jiaming Qian Computerized tomography features acting as predictors for invasive therapy in the management of Crohn’s disease-related spontaneous intra-abdominal abscess: experience from long-term follow-up BMC Medical Imaging Crohn’s disease Spontaneous intra-abdominal abscess Percutaneous drainage Surgery |
| title | Computerized tomography features acting as predictors for invasive therapy in the management of Crohn’s disease-related spontaneous intra-abdominal abscess: experience from long-term follow-up |
| title_full | Computerized tomography features acting as predictors for invasive therapy in the management of Crohn’s disease-related spontaneous intra-abdominal abscess: experience from long-term follow-up |
| title_fullStr | Computerized tomography features acting as predictors for invasive therapy in the management of Crohn’s disease-related spontaneous intra-abdominal abscess: experience from long-term follow-up |
| title_full_unstemmed | Computerized tomography features acting as predictors for invasive therapy in the management of Crohn’s disease-related spontaneous intra-abdominal abscess: experience from long-term follow-up |
| title_short | Computerized tomography features acting as predictors for invasive therapy in the management of Crohn’s disease-related spontaneous intra-abdominal abscess: experience from long-term follow-up |
| title_sort | computerized tomography features acting as predictors for invasive therapy in the management of crohn s disease related spontaneous intra abdominal abscess experience from long term follow up |
| topic | Crohn’s disease Spontaneous intra-abdominal abscess Percutaneous drainage Surgery |
| url | https://doi.org/10.1186/s12880-024-01475-2 |
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