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Crohn et périnée

Crohn’s disease and the perineum

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Pelvi-périnéologie

Résumé

Les lésions anopérinéales de la maladie de Crohn sont fréquentes. Un bilan clinique et morphologique précis associant examen clinique au besoin sous anesthésie générale et une technique d’imagerie est nécessaire dans la prise en charge des lésions complexes. Le contrôle de la maladie intestinale d’amont est impératif. La prise en charge thérapeutique doit prendre en compte les symptômes du patient et les risques d’hypocontinence. Les lésions primaires doivent être chirurgicalement respectées. Le traitement médicochirurgical est nécessaire pour la prise en charge des fistules complexes. Les molécules anti-TNF représentent un progrès notable dans le traitement des fistules anopérinéales. Les échecs thérapeutiques sont sanctionnés par une chirurgie mutilante.

Abstract

Anoperineal injuries resulting from Crohn’s disease occur frequently. A precise clinical and morphological assessment, combining clinical examination (under general anaesthesia, if necessary) with medical imaging, is required in the care of complex lesions, and the management of proximal intestinal disease is imperative. In addition, the treatment plan must take into account the patient’s symptoms and the risk of incontinence. Primary lesions shouldn’t be removed during surgery. Medical and surgical treatment is necessary for the treatment of complex fistulas. Anti-TNF agents represent significant progress in the treatment of anoperineal fistulas. Treatment failure is an indication for radical surgery.

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Authors and Affiliations

  1. Service de gastroentérologie et nutrition, hôpital Saint-Antoine, 184, rue du Faubourg-Saint-Antoine, F-75012, Paris, France

    V. Sebbagh, J. -F. Contou & J. -P. Gendre

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  1. V. Sebbagh
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  2. J. -F. Contou
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  3. J. -P. Gendre
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Correspondence to V. Sebbagh.

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Sebbagh, V., Contou, J.F. & Gendre, J.P. Crohn et périnée. Pelv Perineol 2, 326–332 (2007). https://doi.org/10.1007/s11608-007-0155-8

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  • DOI: https://doi.org/10.1007/s11608-007-0155-8

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