Crohn 病の肛門病変の病態による分類とその外科的治療ならびに成績

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A series of forty-seven patients with perianal lesion was analyzed. The overall incidence of perianal lesion was 67 %, which was higher in patients with colonic or ileocolic type (70 %, 71 %) than in patients with small intestinal type (30 %), and extremely high in patients with prortitis.<BR>Perianal lesion was classified into periproctal abscess or fistula in ano in thirty-nine patients (83 %), skin tag or anal swelling in fourteen patients (30 %), fissures or ulceration in two (4 %), rectovaginal fistuia in two (4 %) and anal stenosis in three (6 %).<BR>Fistula in ano or periproctal abscess was treated surgically or conservatively. Fourteen patientl underwent lay-open, and four underwent fistulectomy. Among them fourteen patients healed, one underwent seton management, and three underwent proctectomy finally after diverting ostomy. In two other patients with pe-iproctal abscess undergoing diverting ostomy, one underwent ostomy closure after the improvement of abscess, and in another patient proctitis hindered ostomy closure. Anal dilatation was tried in two patients with anal stenosis and difficulty in defecation, and good paliation was obtained.
日本大腸肛門病学会の論文