Incidence and clinical outcomes of intersphincteric abscesses diagnosed by anal ultrasonography in patients with crohn's disease
Version of Record online: 6 JAN 2011
Copyright © 2011 Crohn's & Colitis Foundation of America, Inc.
Inflammatory Bowel Diseases
Volume 17, Issue 10, pages 2102–2108, October 2011
How to Cite
Viganò, C., Losco, A., Caprioli, F. and Basilisco, G. (2011), Incidence and clinical outcomes of intersphincteric abscesses diagnosed by anal ultrasonography in patients with crohn's disease. Inflamm Bowel Dis, 17: 2102–2108. doi: 10.1002/ibd.21596
- Issue online: 11 SEP 2011
- Version of Record online: 6 JAN 2011
- Manuscript Accepted: 2 NOV 2010
- Manuscript Received: 6 OCT 2010
- intersphincteric abscesses;
- anal ultrasound;
- Crohn's disease;
- perianal abscesses
Intersphincteric abscesses have been reported as uncommon manifestations of perianal Crohn's disease (CD) in surgical series, and may be diagnosed earlier by means of anal ultrasonography. The aim of this study was to evaluate the incidence and outcomes of intersphincteric abscess in a prospective cohort of patients with CD referred for perianal symptoms.
Of the 420 patients with CD attending our outpatient clinic over a period of 5 years, 55 (31 males, mean age 38 ± 13 years) underwent anal ultrasonography because of newly developed symptoms suggesting perianal disease; a clinical evaluation and perianal examination was performed on the same day.
An intersphincteric abscess was diagnosed in 23 (42%) of the 55 patients with perianal symptoms, for a total cumulative 5-year incidence of 5% (95% confidence interval [CI]: 3%–7%). During a median follow-up period of 23 months (range 6–53), four of these patients required surgery, four developed a perianal fistula or small ischiorectal abscess not requiring surgery, and 15 experienced a benign course. The patients with a benign course had a longer duration of CD at the time of onset of the perianal symptoms.
Intersphincteric abscesses frequently cause perianal symptoms in patients with CD, and their clinical outcomes vary from rapidly progressive inflammation to a benign self-limiting course. The favorable outcome observed in some patients supports a first-line conservative approach to the condition. (Inflamm Bowel Dis 2011;)