Perianal Lesions in Crohn's Dideade

Chang, Dong Kyung; Kim, Joo Sung; Kim, Tae Ho; Jung, Hyun Chae; Song, In Sung; Kim, Chung Yong

Abstract

BACKGROUND/AIMS: Perianal lesions are often associated with Crohn's disease (CD). As the incidence of CD has apparently increased in Korea, patients with non-healing perianal lesions tend to be diagnosed as CD. We performed this study to elucidate the clinical features, therapeutic responses, and relapse rates of perianal lesions in CD.
METHODS
We retrospectively reviewed medical records of 52 cases with perianal lesions among 117 cases registered as CD in Seoul National University Hospital spanning between 1975 and 1996.
RESULTS
Fistula was observed in 83% of the 52 patients with perianal lesions. Abscess was found in 34% of them. Fissure and stricture were observed in 9% and 2% of the patients, respectively. Perianal lesions precected intestinal symptoms such as abdominal pain or diarrhea in 8% (mean intervals; 26 months). Overall, the mean duration of the clinical perianal lesions was 21 months. Perianal lesions were found in 29% of small bowel type, in 36% of colon type, and in 53% of combined type. The remision rnte after nonspecific conservative treatment was 40%. Those after surgery with conservative treatment and with specific treatment were. 43% and 38%, respectively. On the other hand, the remission rate was 81% after specific medical treatrnent. Cumulative relapse rates were 8% in 1 year, 37% in 5 years, and 43% in 7 years. In case of specific medical treatment, the rates were decreased to 3% in 1 year, 11% in 2 years, and 16% in 5 years.
CONCLUSIONS
Perianal lesions in CD show a good remission rate after the specific medical treatment. In conclusion, CD should be suspected in case of non-healing perianal lesion. After confirming, the appropriate specific medical treatment for CD shoud be applied.