[Surgical indication and outcome of Crohn's disease with special reference to management of anal lesions].

A total of 31 cases of Crohn's disease; 23 males and 8 females; 8 small bowel, 11 colon, 8 both small and large bowels involvement and 4 unknown, were collected and analysed. Twelve cases were treated medically and 19 were operated with 61% of operative and 37% of reoperative rate. There was no death due to Crohn's disease. IVH was successful as non-surgical treatment. Indications for surgery were stricture, fistula formation and unsuccessful medical treatment. Limited resection of the diseased segment was performed and in 4 cases diseased segment was left behind without significant postoperative symptoms. Quality of life of the surgically and medically treated patients was satisfactory except one who had many operations during 20 years and still suffers from Crohn's disease. In 15 (48.4%) periproctal abscess or fistula was associated. There were 2 types of anal lesions, the one being ordinary type of low intersphincteric abscess or fistula and the other complex or Crohn's disease related high abscess or fistula. The former was successfully treated by laying-open whereas the latter was treated rather conservatively by drainage not to damage external sphincter muscles. Outcome of medical and surgical treatment of Crohn's disease was quite satisfactory and operation should not be hesitated in patients with serious complications. Type of anal lesion is to be identified and proper surgical treatment should be performed in feasible cases.