Fistulizing Crohn's Disease Presenting After Surgery on a Perianal Lesion

Pediatrics
Andrew A M SingerJeremy Adler

Abstract

Perianal skin lesions, such as skin tags, can be an early presenting sign of Crohn's disease. Surgical intervention on these lesions may increase the risk of fistula development and lead to worse outcomes. This case series examined 8 patients who underwent surgical intervention on what appeared to be benign perianal skin lesions, only to reveal fistulas leading to the diagnosis of Crohn's disease. This patient population comprised 20% of all pediatric patients with Crohn's disease who had perianal fistula present at diagnosis. The initial type of perianal lesion varied from case to case and included skin tags, hemorrhoids, and perianal abscesses. All of the patients had other presenting features that, in retrospect, may have been attributed to Crohn's disease. None presented solely with a perianal lesion. Four patients had weight loss or growth failure. Most of the remainder had abnormal laboratory test results. These findings should raise the awareness of primary care providers that perianal lesions can be the first presenting sign of possible Crohn's disease in otherwise healthy appearing children. Such children should undergo a thorough evaluation for Crohn's disease before surgical intervention on perianal lesions because s...Continue Reading

Citations

Nov 2, 2016·Journal of Pediatric Gastroenterology and Nutrition·Jeremy AdlerUNKNOWN ImproveCareNow Pediatric IBD Learning Health System
Jun 13, 2017·Journal of Pediatric Gastroenterology and Nutrition·Annecarin BrücknerUNKNOWN CEDATA-GPGE study group
Sep 18, 2020·European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery ... [et Al] = Zeitschrift Für Kinderchirurgie·Annika Mutanen, Mikko P Pakarinen
May 4, 2020·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Andrew A M SingerJeremy Adler
Jul 11, 2021·Advances in Pediatrics·Nathan S Rubalcava, Samir K Gadepalli

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