| Theme |
Current Topics Relating to the Anus |
| Title |
Anorectal Lesions with Inflammatory Bowel Disease |
| Author |
Akira Sugita |
Department of Surgery, Yokohama Municipal Hospital |
| Author |
Kazutaka Koganei |
Department of Surgery, Yokohama Municipal Hospital |
| Author |
Hideaki Kimura |
Inflammatory Bowel Disease (IBD) Center, Yokohama City Univerisity Medical Center |
| Author |
Kyoko Yamada |
Department of Surgery, Yokohama Municipal Hospital |
| Author |
Ryo Niki |
Department of Surgery, Fukuoka Univerisity Chikushi Hospital |
| Author |
Hirosuke Kuroki |
Department of Surgery, Yokohama Municipal Hospital |
| Author |
Fumihiko Kitoh |
Department of Surgery, Yokohama Municipal Hospital |
| Author |
Tsuneo Fukushima |
Matsushima Clinic |
| [ Summary ] |
Management of Crohn's anorectal lesions is required to make precise diagnosis of lesions. These lesions include primary lesions (cavitating ulcer etc), secondary lesions (intractable anal fistula, etc) and incidental lesions. For intractable anal fistula such as intersphincteric, transsphincteric fistula with multiple external openings, seton treatment is effective along with treatment for concomitant active colitis. Fecal diversion should be recommended for patients who have extrasphincteric fistula or have not been helped by seton treatment. Ulcerative colitis is also associated with common anal fistula, or rectovaginal fistula. Local treatment is common surgical procedures used for ulcerative colitis patients with anal fistula. Stapled ilealpouch anal anastomosis is necessary for patients with anal fistula who have severe, or intractable colitis, or those with rectovaginal fistula. |