Crohn’s Disease

Conclusion

Operative treatment of Crohn’s disease is aimed at management of complications of the disease that are refractory to medical treatment. Although permanent cure cannot be expected following surgery, many patients resume longer periods of full remission with a normal lifestyle. Proper surgical treatment in selected patients can also decrease or even abolish the need for immunosupressive and potentially harmful medication for months and years.

Perianal manifestations of Crohn’s disease are very common in children. These include skin tags, fissures and fistulas. In most cases perianal manifestations cause mild symptoms or are asymptomatic. conservative approach is warranted and surgical treatment should be considered only in severely symptomatic high rectoperineal or rectovaginal fistulas that do not respond to infliximab or increased immunosuppressive therapy. If surgery is required for a high perianal fistula resection of the mostly diseased usually left colonic segment and temporary bowel diversion may increase the success rate of the fistula repair. In very severe perianal disease, especially if it is associated with severe rectal manifestation, proctectomy may be the only possibility to guarantee a reasonable quality of life.