Daniel H Present MD

Since the classic paper published by Crohn and colleagues in 1932 describing the chronic inflammatory process of the bowel there have been multiple articles published on the complications of this illness. The description of perianal fistula was followed 6 years later with the incorrect concept that the inflammatory process extended from the bowel down to the perianal area. There are multiple problems that can affect the perianal area, including simple skin tags, fissures, hemorrhoids, high and low fistulas, strictures, rectovaginal fistulas, and, finally, neoplasia. Severe perianal skin excoriation can result in significant discomfort and impaired quality of life. The main purpose of this article is to review the perianal complications with a focus on management of fistulas.

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