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Perianal Crohn's disease

Scott A Strong1

  • 1Departments of Colorectal Surgery and Pathobiology, Cleveland Clinic, Cleveland, Ohio 44195, USA. strongs@ccf.org

Seminars in Pediatric Surgery
|July 3, 2007
PubMed

Insights

Perianal Crohn's disease in children involves varied anal and skin lesions. Management requires thorough evaluation and combined therapies, including medications and conservative surgery, to improve symptoms while preserving function.

Area of Science:

  • Pediatric Gastroenterology
  • Colorectal Surgery
  • Inflammatory Bowel Disease Research

Background:

  • Perianal Crohn's disease (PCD) in children is a significant complication that can appear before or after intestinal symptoms.
  • PCD manifests in diverse ways, including skin lesions, anal canal abnormalities, abscesses, fistulas, and rare malignancies.
  • Effective management hinges on comprehensive assessment of the perianal region and the entire gastrointestinal tract.

Purpose of the Study:

  • To outline the varied clinical presentations of perianal Crohn's disease in pediatric patients.
  • To detail the diagnostic approach for perianal Crohn's disease in children.
  • To review current therapeutic strategies for managing pediatric perianal Crohn's disease.

Main Methods:

  • Literature review of perianal Crohn's disease in pediatric populations.
  • Analysis of diagnostic modalities for perianal abnormalities.
  • Synthesis of treatment guidelines encompassing medical and surgical interventions.

Main Results:

  • Perianal lesions in children with Crohn's disease are heterogeneous, impacting skin, anal canal, and potentially leading to abscesses or fistulas.
  • A multidisciplinary approach integrating gastroenterology and surgery is crucial for accurate diagnosis and tailored treatment.
  • Therapeutic options include antibiotics, immunomodulators, biologics, and conservative surgical procedures.

Conclusions:

  • Perianal Crohn's disease requires prompt and thorough evaluation in pediatric patients.
  • Integrated medical and surgical management aims to alleviate symptoms and maintain anorectal function.
  • Long-term monitoring is essential for managing this chronic condition in children.

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