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A Multi-Disciplinary Approach to Perianal Fistulizing Crohn's Disease
Jacob Wiseman1, Tanya Chawla2, Frederic Morin3
1Division of Gastroenterology, Mount Sinai Hospital, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Clinics in Colon and Rectal Surgery
|January 24, 2022
Summary
Perianal fistulizing Crohn's disease is severe and impacts quality of life. Management requires a multidisciplinary team, including gastroenterologists, surgeons, and radiologists, using advanced imaging like MRI.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Radiology
Background:
- Perianal fistulizing Crohn's disease is a severe phenotype.
- Associated with high morbidity and reduced quality of life.
- Increased risk of distal rectal and anal cancers.
Purpose of the Study:
- To highlight the complexity of managing perianal fistulizing Crohn's disease.
- To emphasize the critical role of a multidisciplinary team approach.
- To discuss diagnostic and management strategies, including imaging.
Main Methods:
- Multidisciplinary team approach involving gastroenterologists, colorectal surgeons, and radiologists.
- Examination under anesthesia for critical diagnostic information.
- Utilization of various imaging modalities, with magnetic resonance imaging (MRI) as the preferred choice.
Main Results:
- Perianal fistulizing Crohn's disease necessitates specialized care due to its severity.
- Multidisciplinary collaboration is essential for effective diagnosis and management.
- MRI is the imaging modality of choice for characterizing anatomy and treatment response.
Conclusions:
- Effective management of perianal fistulizing Crohn's disease requires a coordinated multidisciplinary effort.
- Accurate diagnosis and monitoring, particularly using MRI, are crucial.
- Post-ileal pouch-anal anastomosis fistulizing disease presents unique challenges requiring integrated clinical and radiological assessment.
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