P351 Spontaneous intra-abdominal abscesses in Crohn’s disease: The experience of a tertiary centre
Bibliographic record
Abstract
Abstract Background Crohn’s Disease (CD) is a transmural inflammatory disease with the possibility of pan-gastrointestinal involvement that could lead in 10–30% of the cases to spontaneous intra-abdominal abscesses (SIAP). Their management is multidisciplinary and personalised. Our goal was to describe the acute management of SIAP in our centre, as well the recurrence rate of abscess and the need of elective surgery. Methods We retrospectively reviewed medical records of CD patients who have been admitted for intra-abdominal abscess between April 2009 and August 2017. Patients with secondary or perianal abscesses were excluded. Results 24 patients were included in this study with a mean time of hospital stay of 22.13 days. Seventy-nine per cent were male, the mean age was 39 years and 50% were smokers. According to Montreal’s Classification: 62,5% were A2, 58,5% L1 and 75% B3 (+p in 8,3%). 9 were under immunosuppressants (IS), 5 under corticosteroid and 4 under anti-TNF(2 combo therapy). All patients were admitted at the emergency room, more frequently with abdominal pain. 20,8% had SIAP as the first manifestation of CD. The most frequent location was inner loops(mean size was 5.54 cm (0.5–13 cm)). All the patients were prescribed with antibiotics; 10 had only antibiotic; 10 also performed percutaneous drainage(PD); 3 underwent surgical drainage, and 1 suffer from spontaneous drainage by an enterocutaneous fistula. Treatment failure was seen in 1 patient of antibiotic and PD groups. 83,3% underwent exclusive enteral nutrition during the hospital stay. 36,4% started corticotherapy. During follow-up, 33,3% added anti-TNF and 15 patients underwent elective surgery ±11.1 month after the discharge. Only 1 relapse of the SIAP was identified after 8 months of discharge. No deaths due CD were observed. Conclusion Our population consisted of predominately in young males, with younger age at the diagnose of CD, with ileal involvement and under IS. 5 patients had SIAD as the first manifestation of CD. The majority of the SIAP was controlled in acute context with only 1 patient showing a recurrence of SIAP. 15 patients needed elective surgery in the follow-up period, and 33,3% escalated medical therapy. Our results regarding the need for elective surgery aren’t far from published. More studies with larger cohorts are needed highlighting the individual management of each patient.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".