Perianal Crohn's Disease

Diseases of the Colon and Rectum
Amy L Lightner

Abstract

A 22-year-old man presents to your office with a perianal abscess and occasional mild crampy abdominal pain. You take him to the operating room for an examination under anesthesia (EUA) with incision and drainage of the abscess and note a transphincteric fistula tract through which you place a seton and 2 large skin tags. The anal canal and rectum are without ulceration, but there are mild proctitis and nonprolapsing internal hemorrhoids. Because of a concern for Crohn's disease (CD), he undergoes magnetic resonance enterography and colonoscopy. The magnetic resonance enterography shows inflammation in 20 cm of the distal terminal ileum, and colonoscopy reveals approximately 10 ulcers <5 mm in the terminal ileum without significant narrowing. He is seen in consultation for the initiation of a monoclonal antibody and returns to see you in the office after his first 3 infusions. He is feeling well, has significantly decreased drainage from the perianal fistula, but would really like his seton and skin tags removed while you are there.

References

Mar 23, 2002·Gastroenterology·David A SchwartzWilliam J Sandborn
Feb 27, 2004·The New England Journal of Medicine·Bruce E SandsSander J van Deventer
Mar 23, 2010·Diseases of the Colon and Rectum·Ali Soltani, Andreas M Kaiser
Jun 19, 2012·Diseases of the Colon and Rectum·Tim W EglintonFrank A Frizelle
Aug 13, 2015·Alimentary Pharmacology & Therapeutics·S SinghE V Loftus
Apr 4, 2017·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·J P KamińskiP Fleshner
Oct 23, 2018·Inflammatory Bowel Diseases·Sang Hyoung ParkEdward V Loftus
Oct 4, 2019·Diseases of the Colon and Rectum·Nicholas P McKennaKellie L Mathis

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Citations

Jul 10, 2021·World Journal of Gastroenterology : WJG·Oliver Schwandner

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