All practitioners caring for patients with Crohn's disease (CD) must know all the various aspects of anoperineal lesions in this singular entity. Suppuration in CD does not follow the classic routes and spaces of diffusion and is often associated with endolumenal lesions that can evolve on their own. Abscesses and fistulas require specific medico-surgical management where seton drainage, staged operative and sphincter-sparing procedures have a dominant place. The variability of associated lesions and the particularly individualized efficacy of drugs call for case-by-case management, thus, making standardization and comparisons difficult. Recent therapeutic progress has led to modifications of the minimally invasive management policies practiced in the last decades.
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[Management of secondary lesions in ano-perineal Crohn's disease].
Rev Prat
March 2023
Service de proctologie médico-chirurgicale, groupe hospitalier Paris Saint-Joseph, Paris, France.
MANAGEMENT OF SECONDARY LESIONS IN ANO-PERINEAL CROHN'S DISEASE. Anoperineal involvement in Crohn's disease is common and affects around 1/3 of patients during their disease. It constitutes a pejorative factor with an increased risk of permanent colostomy and proctectomy and is associated with a major deterioration in quality of life.
View Article and Find Full Text PDFNatural History of Anal Ulcerations in Pediatric-Onset Crohn's Disease: Long-Term Follow-Up of a Population-Based Study.
Am J Gastroenterol
September 2023
Lille University Hospital, Public Health, Epidemiology, and Economic Health, EPIMAD Registry, Regional House of Clinical Research, Lille, France.
Article Synopsis
- Anal ulcerations are common in pediatric patients with Crohn's disease, with 25.6% experiencing them at diagnosis, and the 5 and 10-year cumulative incidence being 38.4% and 44.0%, respectively.
- Extraintestinal symptoms and locations of Crohn's disease in the upper digestive tract increase the risk of developing anal ulcerations, while ileal locations reduce that risk.
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Anogenital symptoms and lesions in a series of 20 patients infected with monkeypox virus.
Colorectal Dis
May 2023
Service de Gastro-entérologie et Proctologie, AP-HP, Hôpital Bichat Claude-Bernard, Paris, France.
Aim: Monkeypox virus (MPXV) has been spreading in many European countries, the USA and Canada since May 2022. General symptoms, skin and anoperineal lesions have been reported. Anal pain is often reported, but anal canal lesions have yet to be described in these patients.
View Article and Find Full Text PDFManagement of perianal fistulas in Crohn's disease: a 2021 update of the French National Society of Coloproctology consensus.
Tech Coloproctol
October 2022
Digestive Diseases Unit, CHU Pontchaillou, 2 rue Henri Le Guilloux, 35033, Rennes, France.
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- Recent consensus guidelines were developed by the Société Nationale Française de Coloproctologie (SNFCP) to improve treatment strategies for perianal fistulas in Crohn's disease patients, following earlier publications recommending targeted combotherapy.
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A Preclinical Validation of Iron Oxide Nanoparticles for Treatment of Perianal Fistulizing Crohn's Disease.
Int J Mol Sci
July 2022
Centre de Recherche sur l'Inflammation, INSERM, U1149, CNRS, ERL8252, Université Paris Cité, Team Gut Inflammation, BP 416, 75018 Paris, France.
Fistulizing anoperineal lesions are severe complications of Crohn's disease (CD) that affect quality of life with a long-term risk of anal sphincter destruction, incontinence, permanent stoma, and anal cancer. Despite several surgical procedures, they relapse in about two-thirds of patients, mandating innovative treatments. Ultrasmall particles of iron oxide (USPIO) have been described to achieve in vivo rapid healing of deep wounds in the skin and liver of rats thanks to their nanobridging capability that could be adapted to fistula treatment.
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