Gastroenterology MCQ Answer 17

Answer: b, c

A common manifestation of Crohn’s disease is perianal disease, including anal fistulas with extension into the adjacent organs and soft tissue regions, fissures, and perirectal abscesses. The prevalence of perianal disease approaches 25% for patients with ileitis, 50% for ileocolitis, and 40% for those with isolated colonic involvement. Perianal disease is one of the initial signs of presentation in one-third of patients. Although broad spectrum antibiotics are clearly indicated for septic complications of Crohn’s disease, their use as a primary treatment has generally been met without success. Metronidazole has been used effectively in the treatment of perianal disease. In general, a conservative surgical approach to perianal disease is usually prudent. Many patients who have indolent anal fistulas can live comfortably with their disease for years. Although the development of an abscess requires conventional drainage depending on the state of Crohn’s involvement of the rectum, standard surgical procedures can be applied to most forms of perirectal and perianal disease. Proctectomy may be indicated for patients with advanced perianal disease in direct continuity with active rectal involvement.

Category: Gastroenterology MCQs