Similar Long-Term Outcomes in Children Presenting With Abscess vs Phlegmon at Diagnosis of Crohn Disease

Andrew W Fondell; Maua H Mosha; Ross M Maltz; Brendan M Boyle; Barbara Joanna Niklinska-Schirtz; Subra Kugathasan; Meghan E Gibson; Jason M Shapiro; Sarah M Rosenheck; Annette L Langseder; Mary C Kennedy; Joel R Rosh; Jeffrey S Hyams

doi:10.1093/crocol/otaa060

Similar Long-Term Outcomes in Children Presenting With Abscess vs Phlegmon at Diagnosis of Crohn Disease

Crohns Colitis 360. 2020 Jul 20;2(3):otaa060. doi: 10.1093/crocol/otaa060. eCollection 2020 Jul.

Authors

Andrew W Fondell¹, Maua H Mosha¹, Ross M Maltz^{2

3}, Brendan M Boyle², Barbara Joanna Niklinska-Schirtz⁴, Subra Kugathasan⁴, Meghan E Gibson⁵, Jason M Shapiro⁵, Sarah M Rosenheck^{6

7}, Annette L Langseder^{6

7}, Mary C Kennedy^{6

7}, Joel R Rosh^{6

7}, Jeffrey S Hyams¹

Affiliations

¹ Division of Digestive Diseases, Hepatology, and Nutrition, Connecticut Children's, Hartford, Connecticut, USA.
² Division of Pediatric Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, Columbus, Ohio, USA.
³ The Center of Microbial Pathogenesis, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA.
⁴ Division of Pediatric Gastroenterology, Children's Healthcare of Atlanta, Atlanta, Georgia, USA.
⁵ Division of Pediatric Gastroenterology, Nutrition, and Liver Diseases, Hasbro Children's Hospital, Providence, Rhode Island, USA.
⁶ Department of Pediatric Gastroenterology, Goryeb Children's Hospital-Atlantic Health, Morristown, New Jersey, USA.
⁷ Department of Clinical Development and Research Affairs, Goryeb Children's Hospital-Atlantic Health, Morristown, New Jersey, USA.

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.

Keywords: Crohn disease; abscess; children; inflammatory bowel disease; phlegmon.