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Perineal Crohn's disease.

R M Holland, F C Greiss

    Obstetrics and Gynecology
    |October 1, 1983
    PubMed
    Summary
    This summary is machine-generated.

    Crohn's disease frequently causes rectovaginal fistulas, a link often overlooked in gynecology. Early gastroenterologic evaluation and conservative management are crucial due to poor perineal healing in Crohn's patients.

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    International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics·1991

    Area of Science:

    • Gastroenterology
    • Gynecology
    • Colorectal Surgery

    Background:

    • Crohn's disease (CD) is an inflammatory bowel disease with frequent perineal manifestations.
    • Rectovaginal fistulas are a significant, yet often unrecognized, perineal complication of Crohn's disease.

    Observation:

    • This study presents six cases of rectovaginal fistulas associated with Crohn's disease.
    • A review of existing literature highlights the underrecognition of this association in gynecologic practice.

    Findings:

    • A high index of suspicion is necessary for diagnosing rectovaginal fistulas in Crohn's disease patients.
    • Conservative management is recommended due to the poor healing capacity of perineal tissues in this population.
    • Surgical options range from local repair (high recurrence risk) to total proctocolectomy/ileostomy (curative but radical).

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    Implications:

    • Emphasizes the need for gastroenterologic evaluation in patients with rectovaginal fistulas.
    • Highlights the challenges in managing these fistulas, requiring careful consideration of surgical risks and benefits.
    • Stresses the importance of thorough patient counseling regarding treatment outcomes and surgical ramifications.