ABSTRACT
A. O. Hughes and B. M. Taylor describe “the presence of the highly specific lesions in the anal region” as “a fascinating and puzzling aspect of Crohn’s disease”. There are major differences: anal lesions can be observed and examined and their evolution easily followed; and the anal area differs fundamentally from the intestinal sites of the disease by the presence of the sphincteric mechanism. Some of the granulomatous manifestations in the anal area like dermatitis, skintags, fissures, or even low fistulas are trivial. These lesions can be treated along the normal therapeutic guidelines. Continence is jeopardized in several ways by Crohn’s disease of the anus. It is clear that inconsiderate or inadequate surgical treatment can result in sphincter insufficiency. Anovaginal fistulas are quite frequent in female patients with anal Crohn’s disease. They occur either as an isolated lesion or as part of a polymorphous Crohn complex of the anal region, together with other fistulous tracts or lesions.
