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Imaging techniques and combined medical and surgical treatment of perianal Crohn’s disease

Journal of Ultrasound volume 18, pages 19–35 (2015)Cite this article

Abstract

Crohn’s disease is a chronic inflammatory disease which may involve any segment of the gastrointestinal tract, most frequently the terminal ileum, the large intestine, and the perianal region. The symptoms of perianal Crohn’s disease include skin disorders, hemorrhoids, anal ulcers, anorectal stenosis, perianal abscesses and fistulas, rectovaginal fistulas and carcinoma of the perianal region. The perianal manifestations of Crohn’s disease cause great discomfort to the patient and are among the most difficult aspects to treat. Management of perianal disease requires a combination of different imaging modalities and a close cooperation between gastroenterologists and dedicated surgeons.

Riassunto

La malattia di Crohn è una malattia infiammatoria cronica che può coinvolgere qualsiasi segmento del tratto gastroenterico, più frequentemente l’ileo terminale, il grosso intestino e la regione perianale. Le manifestazioni della malattia di Crohn perianale comprendono: alterazioni cutanee, emorroidi, ulcere anali, stenosi ano-rettali, ascessi e fistole perianali, fistole retto-vaginali e cancro della regione perianale. Le manifestazioni perianali della malattia sono una delle principali fonti di disagio per il paziente ed uno degli aspetti della malattia di Crohn più difficili da trattare. La gestione della malattia perianale richiede un’integrazione fra differenti metodiche di imaging e una stretta collaborazione fra gastroenterologi e chirurghi dedicati.

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Conflict of interest

Fiorenzo Botti, Alessandra Losco, Chiara Viganò, Barbara Oreggia, Matteo Prati and Ettore Contessini Avesani declare that they have no conflict of interest related to this article.

Informed consent

No patient information was included in this study. However, the authors have the patients’ consent to the publication of images that could potentially lead to their identification.

Human and animal studies

In connection with this study, the authors did not carry out any procedures involving humans or animals.

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Affiliations

  1. Dipartimento di Fisiopatologia Medico Chirurgica e dei Trapianti, Università degli Studi di Milano, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy

    F. Botti & E. Contessini Avesani

  2. UOC Chirurgia Generale e d’Urgenza, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy

    F. Botti, B. Oreggia, M. Prati & E. Contessini Avesani

  3. UO Medicina VI Epatologia e Gastroenterologia, A.O. San Paolo, Milan, Italy

    A. Losco

  4. UO Medicina Interna, Ospedale S. Famiglia Fatebenefratelli, Erba, Italy

    C. Viganò

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  1. F. Botti
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  2. A. Losco
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  3. C. Viganò
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  4. B. Oreggia
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  5. M. Prati
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  6. E. Contessini Avesani
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Correspondence to F. Botti.

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Botti, F., Losco, A., Viganò, C. et al. Imaging techniques and combined medical and surgical treatment of perianal Crohn’s disease. J Ultrasound 18, 19–35 (2015). https://doi.org/10.1007/s40477-013-0042-9

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  • DOI: https://doi.org/10.1007/s40477-013-0042-9

Keywords

  • Crohn’s disease
  • Perianal Crohn’s disease
  • Diagnostic imaging in Crohn’s disease