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Eugene M. W. Ong, Leyla J. Ghazi, David A. Schwartz, Koenraad J. Mortelé, Guidelines for Imaging of Crohn's Perianal Fistulizing Disease, Inflammatory Bowel Diseases, Volume 21, Issue 4, 1 April 2015, Pages 731–736, https://doi.org/10.1097/MIB.0000000000000367
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Perianal fistulizing disease is very common in patients with Crohn's disease and has been reported in up to 38% of these patients.1 Moreover, the presence of complex or multiple fistulas is seen in up to 23% of this group of patients.2 Perianal fistulizing disease is traditionally diagnosed and assessed with clinical evaluation and EUA. Imaging, however, has been used increasingly in patients with Crohn's disease and perianal fistulas to confirm the diagnosis and exclude other underlying causes of pelvic sepsis, to classify the fistula for surgical planning, to predict surgical outcome, to assess for recurrent disease, and to monitor medical therapy.3,–11
In this article, we discuss the practical indications of imaging in patients with Crohn's disease and perianal fistulas. We also address the inherent advantages and disadvantages of the vast array of imaging tests currently available and address the role of imaging in monitoring treatment options.
