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To assess the outcome of initial conservative treatment with antibiotics in non-percutaneously drainable abdominal abscesses (AA) in Crohn's disease.Retrospective cohort study. 53 Crohn's patients with AA were assessed. In 24 cases percutaneous drainage was not possible, and antibiotics were used as initial therapy. Demographic, clinical, analytical and radiological variables were analyzed. Treatment success was defined as no need for further therapy during the next year after AA diagnosis.Antibiotic treatment was successful in 12/24 patients (50%). The remaining 12 patients required surgical treatment for complete resolution. Hospitalization length was 14 ± 10 days in case of success and 55 ± 32 days in case of failure (P < 0.001); total time for resolution was 76 ± 103 days for success cases and 133 ± 125 days for failure cases (P = 0.7). Predictive factors of success were: disease location outside the ileum (P = 0.02), noprior use of immuno-suppressants (P = 0.04) and no evidence of fistula on abdominal CT (P = 0.04).Conservative treatment with antibiotics as a first approach in non-drainable AA in Crohn's disease leads to complete resolution in 50% of cases. Disease location outside the ileum, noprior use of immuno-suppressants and absence of fistula couldpredict the success of this strategy.