Treatment of Crohn's anal fistulas guided by magnetic resonance imaging.
Crohn’s disease
anal fistula
magnetic resonance imaging
Journal
Przeglad gastroenterologiczny
ISSN: 1895-5770
Titre abrégé: Prz Gastroenterol
Pays: Poland
ID NLM: 101280380
Informations de publication
Date de publication:
2019
2019
Historique:
received:
09
09
2018
accepted:
07
10
2018
entrez:
5
4
2019
pubmed:
5
4
2019
medline:
5
4
2019
Statut:
ppublish
Résumé
Clinical evaluation of the Crohn's anal fistulas (CF) closure is inadequate to some extent due to earlier closure of cutaneous openings compared to fistulous tracts. There is a need for a more accurate method of assessment. To compare clinical signs of CF with radiological findings, before and after treatment, to follow complete closure. It was a retrospective study of 23 patients suffering from CF admitted to a single specialist centre, who were treated with a combination of surgical and biological therapy. Fistula healing was evaluated with fistula drainage assessment classification (FDA), perianal disease activity index (PDAI), and van Assche magnetic resonance imaging score (MRI) before and 3 months after surgery and induction of the biological treatment. Clinical response occurred in 13 (57%) patients 3 months after induction treatment. Complete clinical response was achieved in 8 (35%) patients, whereas partial response occurred in 5 (22%) patients. Persistence of a fistula tract was visualised on MRI in 4 (50%) patients with clinical closure. The healing process of CF should be monitored by MRI due to the discrepancy between premature closure of external openings and fistulous tracts. Prolonged biological therapy until complete healing of anal fistulas confirmed on MRI might improve the results of treatment.
Identifiants
pubmed: 30944678
doi: 10.5114/pg.2019.83426
pii: 36009
pmc: PMC6444106
doi:
Types de publication
Journal Article
Langues
eng
Pagination
55-61Déclaration de conflit d'intérêts
The authors declare no conflict of interest.
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