James Donald Byrne BS, Presenter: Nothing to Disclose

Ari Joel Isaacson MD, Abstract Co-Author: Nothing to Disclose

Ryan Stephens MD, Abstract Co-Author: Nothing to Disclose

Hyeon Yu MD, Abstract Co-Author: Nothing to Disclose

Charles Thomas Burke MD, Abstract Co-Author: Nothing to Disclose

Anastomotic leaks are a common complication after bowel surgery in Crohn’s patients. Image-guided percutaneous drainage is an attractive alternative to reoperation because of decreased morbidity and hospital stay. Because data for this specific population is scarce, we aimed to determine the safety and efficacy of image-guided percutaneous drainage in the management of anastomotic leak in Crohn’s patients by retrospectively reviewing cases at a single academic institution.

The medical records of 41 patients with Crohn’s disease who underwent percutaneous drain placement for the treatment of anastomotic leak from September 2004 to November 2013 were reviewed. CT imaging was also reviewed to determine the number, size and locations of the drained fluid collections. Local treatment failures and complications were evaluated for all patients.

The mean volume of the abscesses resulting from anastomotic leak was 167.2 cm3 (median 59.5 cm3; range 1.8-1173.1 cm3), and the mean number of targeted fluid collections per patient was 1.5 (median 1; range 1-4); 15 of 41 (38.1%) patients were treated for multiple abscesses. The mean duration between surgery and percutaneous drain placement was 18.5 days (median 14 days; range 6-60 days), and the median drain size was 10 French, with a range of 8-16 French. Overall, the mean duration of drainage was 70.4 days (median 29 days; range 2-732 days). The mean number of drain manipulations/exchanges was 1.2 (median 0; range 0–14). One of 41 (2.4%) patients experienced minor complications from drain placement, injury to a superficial abdominal artery, and no major complications occurred. Two of 41 (4.9%) patients required repeat surgeries.

Image-guided percutaneous drainage for the treatment of post-surgical anastomotic leaks in Crohn’s patients is effective and safe with low rates of complications and reoperations.

Image-guided percutaneous drainage of anastomotic leaks after bowel surgery in Crohn’s patients is a safe and effective alternative to surgical intervention, reducing morbidity and hospital stay.

Byrne, J, Isaacson, A, Stephens, R, Yu, H, Burke, C, Image-guided Percutaneous Drainage for Treatment of Post-surgical Anastomotic Leak in Patients with Crohn’s Disease.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14001577.html