RECTAL INVOLVEMENT IN CROHN’S DESIASE PATIENTS WITH ANOPERINEAL MANIFESTATIONS

Aims The aim of this study was to evaluate the macroscopic rectal involvement in patients with anoperineal manifestations.

Methods It is a prospective and descriptive study, including Inflammatory Bowel Disease (IBD) patients who were monitored in the gastro intestinal department of our university hospital, and who developed anoperineal manifestations. Epidemiological, clinical and endoscopic data of 164 patients were gathered.

Results In our cohort of 164 patients with Crohn’s disease, 63 had anoperineal manifestations with a prevalence of 38.41 %, among which 64.1% were men; the mean age was 34.3, with ranges from 17 to 64 years old. The median of the disease duration was 8.33 years with a standard deviation of 5.16 years. 22 (35.9%) patients had anoperineal manifestations at the onset of disease while the 41 (65.07 %) remaining developed them later on.

The observed manifestations were fistulas, fissures, skin tags, and abscesses, with the following frequencies respectively 68.8 %, 21.9 %, 18.8 % and 15.6 %. 14 patients had more than one anoperineal lesion at a time with a maximum of 3 for 2 patients (fissure, fistula and skin tag for both).

Ileocoloscopy was performed for 62 patients, while 1 patient had a rectosigmoidoscopy as he was admitted for an acute severe colitis. Endoscopy showed rectal involvement in 28 cases (44.44%), macroscopic rectal mucosal congestion in 7 cases, erosions in 5 and both in 4 cases, while an ulcerative aspect was observed in 8 cases, an erythematous mucosal in 2 cases and an aphthous lesion in one case.

Conclusions The prevalence of anoperineal manifestations in Crohn’s disease within our cohort is 38.41 %. The most frequent manifestation being fistulas with a frequency of 68.8%, macroscopic rectal involvement was observed in 44.44 % of cases.

 

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