Year 2021 / Volume 113 / Number 4
Original
Treatment of abdominal fistulas in Crohn’s disease and monitoring with abdominal ultrasonography

240-245

DOI: 10.17235/reed.2020.6884/2020

Nadia Moreno Sánchez, José María Paredes, Tomas Ripollés, Javier Sanz de la Vega, Patricia Latorre, María Jesús Martínez, José Richart, José Vizuete, Eduardo Moreno-Osset,

Abstract
Objective: to assess the usefulness of medical treatment to achieve closure of internal fistulas detected on abdominal ultrasound in a series of patients with fistulizing Crohn’s disease. Material and methods: a retrospective analysis was performed of the medical records of patients with Crohn’s disease with a fistula detected on abdominal ultrasound from 2010 to 2018. The study included patients who received medical treatment after the diagnosis of this complication and underwent ultrasonographic monitoring of the therapeutic response. The factors associated with the response to medical treatment or the need for surgery were investigated. Results: forty-six patients were included in the study. Enteromesenteric (69.6 %) was the most common type of fistula and associated abscesses were found in 14 (30.4 %) patients. Fistulas were classified as complex in 20 patients. Treatment with immunosuppressants was started in 14 (30.4 %) cases and a biologic drug was added in 18 (39.1 %) patients. Complete closure of the abdominal fistula was observed with ultrasonography in 24 (52.2 %) of the 46 patients. The only factor related to fistula closure was the type of fistula and was more likely to occur in patients with an enteromesenteric fistula. Thirteen (28 %) of the 46 patients needed a surgical resection. The only factor with a significant correlation with a lower need for surgery was fistula closure after treatment (8.3 % vs 50 %, p = 0.002). Conclusion: medical treatment achieves internal fistula closure in more than half of cases and almost a third require surgical treatment. Abdominal ultrasound can detect abdominal fistulas at an earlier stage and allow prompt treatment changes.
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16/09/2022 14:10:33


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Moreno Sánchez N, Paredes J, Ripollés T, Sanz de la Vega J, Latorre P, Martínez M, et all. Treatment of abdominal fistulas in Crohn’s disease and monitoring with abdominal ultrasonography. 6884/2020


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Publication history

Received: 15/01/2020

Accepted: 04/05/2020

Online First: 23/11/2020

Published: 07/04/2021

Article revision time: 102 days

Article Online First time: 313 days

Article editing time: 448 days


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