[Perianal disease in Crohn disease]

The treatment of perianal disease by Morbus Crohn belongs to a general conceptional therapy of this disease and requires close cooperation between gastro-enterologist and surgeon. Primary role in the treatment belongs to the internist, surgeon intervenes only in case of complications or during failure of the conservative treatment. Simple, asymptomatic fistulas are treated conservatively. The fistulas with trouble requires local surgical treatment. In case complicated, multiplied of the fistulas is indicated curative resection of the bowel, if it is indicated from another reasons, in dependence on classical criterions. Temporary derivative colostomy is applied in case, where curative resection is not indicated or if the rectum is not affected or if curative resection and local surgical treatment were ineffective. Proctectomy is applied only during massive affection of rectum and destruction of spincters. Our work confirms that the mentioned surgical methods in treatment of perianal disorder accompanying Morbus Crohn are still valid and the improvement of results in treatment this disease could be expected rather on the field of farmacotherapy.