Problems in Diagnosis of Anal Lesions in Crohn's Disease by Physicians. Discussion on Its Diagnosability.:Discussion on Its Diagnosability

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In 113 cases of Crohn's disease, 90 cases (79.6%) had anal lesions. Those were perianal abscess, anal fistula, swelling of anal papillae, skin tag, anal fissure, and anal ulcer, in this order of frequency. Diagnosis of perianal lesions could be made by inspection and digital examination in 69 cases (61%), in which one of such lesions as perianal abscess, anal fistula, or skin tag was recognized. Diagnosis could not be made by those in 21 cases. Those lesions were low grade anal fissure, anal ulcer, and swelling of anal papillae alone.<BR>As for correlation of anal and enteric lesions, 44 of 55 cases (80.3%) with colonic involvement had anal lesions. The frequency was higher as compared to those without colonic involvement. All cases with rectal involvement had anal lesions.<BR>Detectability of epithelioid cell granulomata in biopsy specimens of lower rectum was 32%.<BR>In conclusion, even a general physician who dosen't employ an anoscope in daily practice can get a clue to diagnosis of Crohn's disease in approximately 60% by detection of anal lesions by means of inspection and digital examination.<BR>Physical examination of anal region is clinically important when Crohn's disease is suspected.
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