Perianal lesion may by the first presenting feature of Crohn´s disease. Perianal disease associated with Crohn´s disease is frequently mild with small perianal skin tags or anal fissures, but more severe problems such as perianal fistulae and abscesses may develop. The cumulative frequency of perianal fistulae ranged from 14 % to 38 % in adults with CD and 13 % in children and adolescents with CD. Less than 5 % of children with CD will develop a highly destructive form of perianal disease with recurrent abscesses and fistulae involving the genitalia, and often resulting in rectal strictures. Antibiotics, immunomodulators, and exclusive enteral or parenteral nutrition are used in the treatment of perianal CD in children. Successful treatment of luminal and fistulizing CD in adults has been reported with infliximab. It has also been shown to be beneficial in the treatment of luminal CD in children and is approved for the treatment of fistulizing CD in adults and luminal disease in adults and children. Retrospective studies in children with CD have shown diminished fistulae and perianal symptoms in response to infliximab therapy.
Keywords: Crohn´s disease (CD), perianal Crohn´s disease, rectal fistula, rectovaginal fistula