Abstract

Perianal disease is one of the most disabling aspects of Crohn's disease. It affects 17%–43% of the patients, especially those with proctitis. Previous management of perianal Crohn's disease was limited to either isolated medical treatment with agents such as antibiotics or immunomodulators or isolated surgical management with incision and drainage procedures, seton placement, and/or fistulotomy. With advancements in both medical (antitumor necrosis alpha agents) and endoscopic options (endoscopic ultrasound), management of perianal Crohn's disease has become a multidisciplinary field involving gastroenterologists and surgeons to optimize the outcomes. This chapter will review advances in endoscopic evaluation and management of perianal Crohn's disease.

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