Open AccessTreatment of peri-anal fistula in Crohn's disease
Author(s) -
Giuseppe Sica,
Sara Di Carlo,
Giorgia Tema,
Fabrizio Montagnese,
Giovanna Del Vecchio Blanco,
Valeria Fiaschetti,
G Maggi,
Livia Biancone
Publication year - 2014
Publication title -
world journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.v20.i37.13205
Subject(s) - medicine , crohn's disease , fistula , anal fistula , surgery , medical therapy , disease , refractory (planetary science) , rectum , medical treatment , perioperative , intensive care medicine , physics , astrobiology
Anal fistulas are a common manifestation of Crohn's disease (CD). The first manifestation of the disease is often in the peri-anal region, which can occur years before a diagnosis, particularly in CD affecting the colon and rectum. The treatment of peri-anal fistulas is difficult and always multidisciplinary. The European guidelines recommend combined surgical and medical treatment with biologic drugs to achieve best results. Several different surgical techniques are currently employed. However, at the moment, none of these techniques appear superior to the others in terms of healing rate. Surgery is always indicated to treat symptomatic, simple, low intersphincteric fistulas refractory to medical therapy and those causing disabling symptoms. Utmost attention should be paid to correcting the balance between eradication of the fistula and the preservation of fecal continence.