PMID: 8951512Jan 1, 1996Paper

Fistulae and abscesses in symptomatic perianal Crohn's disease

International Journal of Colorectal Disease
M J Solomon

Abstract

Perianal disease occurs in up to 90% of patients with Crohn's disease [1-4]. Many of these patients have only mild symptoms or are asymptomatic and thus require no intervention. Clinical features are variable and include hypertrophic skin tags, ulceration, perianal abscess and fistulae, anal canal ulcers, fissures, induration and stenosis. Perianal abscess and fistula often occur simultaneously and are usually symptomatic. Symptoms range from pain, discharge, bleeding, to gross faecal incontinence with restriction of lifestyle and sexual activity. There is little uniformity amongst clinicians in the investigation and management of perianal Crohn's disease [5]. This is due, in part, to the variability in both frequency and severity of attacks and to spontaneous remissions and exacerbations of perianal disease. Secondly, assessment of severity of illness and the response to treatment is difficult to objectively quantitative. Improvement in quality of life is the aim of therapy not cure of perianal disease. Investigative modalities for perianal Crohn's are changing due to the limitations of conventional fistulography, CT scanning and clinical evaluation. MRI scanning has been introduced more recently, however, requires an endorect...Continue Reading

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Dec 28, 2016·Benjamin Misselwitz

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