Question about abcess and resection

My cousin was admitted today to the hospital after suffering since friday with massive pain in the adbomen and fever. She was diagnosed in Jan with CD in the illium and is on pentassa and 10mg predisone and SCD diet. Prior to last friday she was doing really good, no pain for lamost three weeks, and normal BMs.  The ct today showed 7cm by 3 cm abcess filled with fluid in her abdomin near the CD area and the surgeon says it is related to her crohns. He also says the intestine near the illium is inflammed and almost to the point of stricture and she needs to have surgery immediately as soon as the abcess and infection has subsided, maybe in two weeks.  They have her on massive antibiotics, and they want to insert a needle into the abcess to drain it. 

 My question is , has anyone ever had a massive abcess and had it heal with drugs, and avoid having surgery or a resection?  Since she is not having problems passing food and her BMs are normal, would going on humira reduce the inflamation enough to avoid surgery  and avoid the risk of future abcesses?  

Hi NY,

about two years ago I had complications with a pregnancy that included an abscess. Long story short, the abscess was about golf ball size and a small fistula from it to my small intestine. At the time I was tapering off high dose steroids and the dr had just put me on pentasa (even though I had told him it didn't work in the past). When it was discovered, they put me on lots antibiotics and put in a central line for tpn. A day or so later they drained the abscess. The meds and tpn lasted about two weeks. They did a couple of tests (small bowel follow thru and ct, I think) to see if everything was healed. I started Imuran and elemental diet (drink made of amino acids, so that if the whole thing wasn't healed, the amino acids wouldn't create bacteria/infection). Two weeks later I graduated to liquid diet, then low residue, etc. about a month after starting Imuran I started having pain, so we started Remicade. Since then I have been in remission. Due to the flare/pregnancy complications, I have a permanent structure that annoys me from time to time, but other than that am fine.

A couple of things I would like to point out--I am a US citizen and was living in Japan at the time. I don't know what the course of treatment would have been in the US. I know they would have done the antibiotics and drainage, but they may have done a resection, too. The doctor in Japan had US training, but saw something in my case that made him think he could spare me surgery. He didn't guarantee it, but he was positive. As for Remicade, that was the only anti-tnf available to me in Japan at that time. Any of the tnf's should work to bring your cousin into remission.

I think there is one other case like that (abscess, but no surgery) on here. I can't remember his name, but his daughter had something similar to me and at the time I read the posting, she still had not needed surgery. (In some cases, even though surgery is not performed initially, later it is needed)

You may want to get a second opinion on the surgery, but everything else looks like they are following protocol.

Ok, one last thing on the surgery, ask if they want to do it now or AFTER they get rid of the inflammation. It's my understanding that surgery is not indicated until the inflammation is gone. There is plenty of info on that on the web.

I hope this was helpful in some way. Good luck to your cousin.

I had a pelvic abscess about 5 years ago that was treated with anitbiotics only. My GI monitored the abscess through ultrasound to make sure it was shrinking. I never needed surgery and the abscess went away within a few months. I have been on Humira and am now on Remicade and have not had a reoccurance of the abscess. Good luck to your cousin!