Crohn’s fistula: current concepts in management

Abstract

Crohn’s disease was described in 1932 in the classic article by Crohn et al., and then subsequently the authors described one of the disease complications, namely perianal fistula. It was originally thought that the perianal disease originated in the inflamed terminal ileum, which extended internally down to the perianal area. In the last 70 years, we have learned much about this disease, as well as the complications of both perianal and internal fistula. Approximately 60%–70% of all patients with Crohn’s disease will eventually need to undergo surgery, which in many cases is related to the development of a perianal fistula, subsequent to an abscess.1 The purpose of this article is to review our current knowledge of Crohn’s fistula, focusing predominantly on the concepts in clinical management.