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Hépato-Gastro & Oncologie Digestive

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Surgical therapy for peri-anal Crohn's disease Volume 20, issue 10, Décembre 2013

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Authors
Groupe Hospitalier Paris Saint-Joseph, Institut Léopold Bellan, service de proctologie médico-chirurgicale, 185 rue Raymond Losserand, 75014 Paris, France, Université Denis Diderot, Sorbonne Paris Cité et Hôpital Lariboisière, service d’hépato-gastro-entérologie 2, rue Ambroise-Paré, 75010 Paris, France

Perianal Crohn's disease has been reported in half of patients with Crohn's disease and is associated with a more severe course of disease. The manifestations of perianal Crohn's disease vary from primary lesions such as skin tags and fissures, to diffuse septic destruction. Optimal treatment requires close multidisciplinary teamwork. Fistula management remains a challenge for both gastroenterologists and surgeons. The goals of treatment are resolution of fistula discharge and preservation of continence. Abscess drainage is mandatory prior to immunosuppressive medical therapy. Non-cutting Seton placement has a key role in therapeutic strategy as well as sphincter-sparing techniques.