| Surgical management of anorectal fistulas in Crohn's disease. | |
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MedLine Citation:
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PMID: 2791786 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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A retrospective review of patients with Crohn's disease treated at our institution from 1973 to 1986 revealed 35 patients operated upon for anorectal fistulas. Twenty-nine had low intermuscular fistulas (multiple in seven), and six had high intermuscular (supralevator) fistulas. Fistulotomy alone was performed in 19 patients, and eight underwent partial fistulotomy and seton insertion. Five additional patients had proximal fecal diversion before fistulotomy. Three patients with severe colonic and anorectal disease underwent proctocolectomy as the initial procedure. Of the 32 patients who had fistulotomy performed, complete healing occurred in 30. Seven patients who healed required more than one operation for fistula. One patient was left with an asymptomatic fistula, and one required proctectomy for persistent symptomatic fistula and proctitis. Success of operation correlated with absence of rectal disease and quiescent disease elsewhere in the gastrointestinal tract. Aggressive medical treatment is required to control bowel disease preoperatively. In the majority of patients, subsequent surgery is justified and healing can be anticipated. |
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Authors:
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J G Morrison; J B Gathright; J E Ray; B T Ferrari; T C Hicks; A E Timmcke |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Diseases of the colon and rectum Volume: 32 ISSN: 0012-3706 ISO Abbreviation: Dis. Colon Rectum Publication Date: 1989 Jun |
Date Detail:
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Created Date: 1989-10-31 Completed Date: 1989-10-31 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0372764 Medline TA: Dis Colon Rectum Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 492-6 Citation Subset: IM |
Affiliation:
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Department of Colon and Rectal Surgery, Ochsner Clinic, New Orleans, Louisiana 70121. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Crohn Disease / complications* Follow-Up Studies Humans Methods Middle Aged Prognosis Rectal Fistula / etiology, pathology, surgery* Recurrence Reoperation Retrospective Studies |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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