title: Anovaginal and rectovaginal fistula in patients with Crohn's disease.
abstract: Between 1971 and 1991, details of 67 women with perianal Crohn's disease were recorded prospectively using the Cardiff classification. Two groups were identified according to the presence (n = 29) or absence (n = 38) of anorectal Crohn's fistula involving the vagina. Patients in both groups were of a similar age and had had Crohn's disease for a similar period before diagnosis of perianal involvement. The incidence of associated perianal lesions, superficial ulcers, cavitating ulcers, other fistulas and strictures was not significantly different between the two groups. A greater proportion of patients with anorectal-vaginal fistulation (n = 15) had distal intestinal Crohn's disease (rectal or contiguous colorectal) compared with women with no vaginal fistulation (n = 14). A range of therapies was used to manage women with perianal Crohn's disease, from local surgery to a defunctioning stoma and/or proctectomy. Only 13 of 38 women with perianal Crohn's disease but no vaginal fistula required a defunctioning stoma or proctectomy, whereas 18 of 29 with anorectal-vaginal fistulation underwent these procedures (P < 0.05). A vaginal fistula has a considerable adverse effect on the outcome of perianal Crohn's disease.
authors: University Department of Surgery, University of Wales College of Medicine, Heath Park, Cardiff, UK.
authors: N A
authors: NA
authors: Scott
authors: A
authors: A
authors: Nair
authors: L E
authors: LE
authors: Hughes
mesh_terms: D000328:Adult; D003092:Colitis / Q000150:complications; D003251:Constriction, Pathologic / Q000209:etiology; D003424:Crohn Disease / Q000150:complications* / Q000601:surgery; D005260:Female; D006801:Humans; D015994:Incidence; D011349:Proctitis / Q000150:complications; D011446:Prospective Studies; D012006:Rectovaginal Fistula / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery