Penetrating ileocolic Crohn disease with intra-abdominal abscess: diagnose, drugs, drain, divert?

Penetrating terminal ileitis with abscesses was associated with adverse outcomes after ileocolic resection for Crohn disease. Optimal management includes preoperative diagnosis with repeated imaging at appropriate intervals preoperatively, antibiotic therapy, percutaneous drainage when indicated with maintenance of the drain until surgery, and selective diversion.