Côlon & Rectum

, Volume 1, Issue 2, pp 100–105 | Cite as

Prise en charge des fistules anales au cours de la maladie de Crohn

  • X. Tréton
  • A. Senéjoux
Dossier Thématique / Thematic File

Résumé

La maladie de Crohn peut se compliquer de lésions anopérinéales à type d’abcès et de fistules. La prise en charge initiale des abcès est le plus souvent un drainage chirurgical avec mise en place d’un séton lâche. Les récidives sont fréquentes à l’ablation du séton. La fistulotomie est habituellement contre-indiquée au cours de la maladie de Crohn en raison du risque de survenue d’une incontinence fécale. Un traitement médical est fréquemment associé une fois la suppuration drainée: les anti-TNFα ont fait la preuve de leur efficacité dans cette indication dans des essais randomisés contrôlés, les autres immunosuppresseurs pouvant aussi être utilisés.

Mots clés

Crohn Anus Fistule Infliximab Chirurgie 

Treatment of anal fistulas in patients with Crohn’s disease

Abstract

Anoperineal abscesses and fistulas can occur during the course of Crohn’s disease. Most often, the initial treatment of a perineal abscess is to drain it by inserting a loose seton. Recurrence is frequent after seton removal. Fistulotomy is usually contraindicated in patients with Crohn’s disease because fecal incontinence is a possible complication. Medical treatment frequently follows suppuration drainage. Anti-TNFα therapy has demonstrated its efficacy in randomized, controlled trials, and other immunosuppressants can also be administered.

Keywords

Crohn Anus Fistulas Infliximab Surgery 

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Copyright information

© Springer Verlag France 2007

Authors and Affiliations

  • X. Tréton
    • 1
  • A. Senéjoux
    • 1
  1. 1.PMAD, hôpital BeaujonClichyFrance

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