| Theme |
Benign Lesions of Rectum and Anus |
| Title |
Anal Fistulas--Especially, Perianal Lesions in Crohn's Disease |
| Author |
Kazuo Hase |
Department of Surgery, Self-defense Forces Central Hospital |
| Author |
Masayoshi Miyoshi |
Department of Surgery, Self-defense Forces Central Hospital |
| [ Summary ] |
Crohn's disease is often accompanied by perianal lesions which can be difficult to treat. Anal fistulas are the most common anal complications in this disease. Anal fistulas become more complicated or resistant in patients with colonic disease than in patients with small intestinal disease. Anal fistulas in Crohn's disease are frequently complicated, intractable, and wide-spread lesions accompanied with multiple fistula openings. The specific morphology and the course of anal fistulas often provide clues for discovery of intestinal Crohn's disease in the absence of obvious clinical manifestations of it. As for the treatment of Crohn's fistulas, systemic therapy to alleviate the intestinal in flammation should be taken priority. For simple or low perianal fistulas, surgical removal can be carried out resulting in almost complete cure. For complexed or high fistulas, it is suggested that nonradical, conservative surgical treatment such as seton suture provide and maintain satisfactory patients' quality of life. |