{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T01:00:42Z","timestamp":1785114042000,"version":"3.55.0"},"reference-count":52,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T00:00:00Z","timestamp":1762732800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Intra-abdominal abscess (IAA) is a serious complication of Crohn\u2019s disease (CD). Management strategies include medical therapy, percutaneous drainage (PD), and initial surgery, but the optimal approach is debated. We performed a systematic review and meta-analysis to compare these strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search of 4 electronic databases was conducted. The primary outcome was the need for surgical intervention (resection or reoperation). Secondary outcomes included recurrence and complications. Data were pooled using random-effects models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-three studies were included. Compared with initial surgery, both PD (odds ratio [OR], 5.28; 95% confidence interval [CI], 1.65-16.91) and medical management (antibiotics alone \u00b1 corticosteroids) (OR, 4.40; 95% CI, 1.25-15.45) were associated with significantly higher odds of requiring surgical intervention, relative to the reoperation rate in the surgery group. PD was associated with significantly lower odds of overall postintervention complications compared with initial surgery (OR, 0.48; 95% CI, 0.23 to 0.96), with no significant difference in length of stay. Adjunctive exclusive enteral nutrition was associated with a significant reduction in the need for subsequent surgery (OR, 0.26; 95% CI, 0.10 to 0.67). Pooled proportions for requiring subsequent surgery were 48% for medical management, 47% for PD, and 21% for the reoperation rate in the initial surgical group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Initial surgical management is the most definitive treatment for CD-related IAA, with the lowest reoperation rates. PD serves as a less invasive bridge to surgery that reduces postintervention complications. Medical management alone is less effective and should be reserved for select patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ibd\/izaf242","type":"journal-article","created":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T11:42:27Z","timestamp":1762774947000},"page":"474-487","source":"Crossref","is-referenced-by-count":2,"title":["Initial Management of Intra-Abdominal Abscess in Crohn\u2019s Disease: A Systematic Review and Meta-Analysis"],"prefix":"10.1093","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1673-7792","authenticated-orcid":false,"given":"Mohammed Nabil","family":"Quraishi","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Sheikh Shakhbout Medical City, Pure Health , Abu Dhabi,","place":["United Arab Emirates"]},{"name":"College of Medicine and Health Sciences, Khalifa University of Science and Technology , Abu Dhabi,","place":["United Arab Emirates"]},{"name":"Institute of Cancer and Genomic Sciences, University of Birmingham , Birmingham,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam Al","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Sheikh Shakhbout Medical City, Pure Health , Abu Dhabi,","place":["United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noura Al","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Sheikh Shakhbout Medical City, Pure Health , Abu Dhabi,","place":["United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert Douglas","family":"Church","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Sheikh Shakhbout Medical City, Pure Health , Abu Dhabi,","place":["United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3905-2903","authenticated-orcid":false,"given":"Badr","family":"Al-Bawardy","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, King Faisal Specialist Hospital and Research Center , Riyadh,","place":["Saudi Arabia"]},{"name":"Department of Internal Medicine, Section of Digestive Diseases, Yale School of Medicine , New Haven, CT,","place":["United States"]},{"name":"College of Medicine, Alfaisal University , Riyadh,","place":["Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,11,10]]},"reference":[{"key":"2026030209524285600_izaf242-B1","doi-asserted-by":"crossref","first-page":"2066","DOI":"10.1056\/NEJMra0804647","article-title":"Inflammatory bowel disease","volume":"361","author":"Abraham","year":"2009","journal-title":"N Engl J Med"},{"key":"2026030209524285600_izaf242-B2","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1016\/S0140-6736(23)02586-2","article-title":"Crohn\u2019s disease","volume":"403","author":"Dolinger","year":"2024","journal-title":"Lancet"},{"key":"2026030209524285600_izaf242-B3","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1097\/00054725-200207000-00002","article-title":"Long-term evolution of disease behavior of Crohn\u2019s disease","volume":"8","author":"Cosnes","year":"2002","journal-title":"Inflamm Bowel Dis"},{"key":"2026030209524285600_izaf242-B4","doi-asserted-by":"crossref","first-page":"1785","DOI":"10.1053\/j.gastro.2011.01.055","article-title":"Epidemiology and natural history of inflammatory bowel diseases","volume":"140","author":"Cosnes","year":"2011","journal-title":"Gastroenterology"},{"key":"2026030209524285600_izaf242-B5","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1053\/gast.2002.32362","article-title":"The natural history of fistulizing Crohn\u2019s disease in Olmsted County, Minnesota","volume":"122","author":"Schwartz","year":"2002","journal-title":"Gastroenterology"},{"key":"2026030209524285600_izaf242-B6","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1159\/000367859","article-title":"Abdominal abscess in Crohn\u2019s disease: multidisciplinary management","volume":"32 Suppl 1","author":"de Groof","year":"2014","journal-title":"Dig Dis"},{"key":"2026030209524285600_izaf242-B7","doi-asserted-by":"crossref","first-page":"1346","DOI":"10.1016\/j.cgh.2019.12.040","article-title":"Inpatient management of inflammatory bowel disease related complications","volume":"18","author":"Kaur","year":"2020","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2026030209524285600_izaf242-B8","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1002\/ueg2.12342","article-title":"Intra-abdominal abscesses in CD\u2014When to treat with biologics? 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