Krieg H, Brünner H, Gamstätter G, Grönniger J
MMW Munch Med Wochenschr. 1977 Feb 11;119(6):193-6.
Anal and perianal lesions in Crohn's disease such as fistulae, fissures, abscesses and proliferative ulcerous proctitis are often misinterpreted and consequently unsatisfactorily treated. They always indicate a florid intestinal attack or a relapse after previous intestinal resection. Out of 153 patients with Crohn's disease in the last 11 years we have had 59 cases (= 38.6%) with a history of anal changes or such changes were demonstrable on admission to hospital. Only after subtle diagnosis in which the nature and extent of these complications and the location of the intestinal disease focus are determined, the most promising therapy, after all possibilities of conservative treatment have been exhausted, is intestinal resection. Local surgical measures which would often endanger continence, are reserved for the individual case.
克罗恩病的肛门和肛周病变,如瘘管、肛裂、脓肿和增殖性溃疡性直肠炎,常常被误诊,因此治疗效果不佳。这些病变总是提示肠道炎症活跃发作或既往肠道切除术后复发。在过去11年里,我们诊治的153例克罗恩病患者中,有59例(占38.6%)有肛门病变史,或入院时可发现此类病变。只有在明确诊断,确定这些并发症的性质、范围以及肠道疾病病灶的位置后,在保守治疗的所有可能性均已用尽时,最有前景的治疗方法才是肠道切除。那些常常会危及控便功能的局部手术措施,则需根据个案情况决定是否采用。