Hyperbaric oxygenation in severe perineal Crohn's disease.
OBJECTIVE
Perineal involvement in Crohn's disease is a common and distressing condition, often refractory to medical or surgical treatments. Recent reports suggest the efficacy of hyperbaric oxygenation (HBO) in the healing of perineal lesions. We evaluated HBO in severe patients with perineal Crohn's disease.


METHODS
Ten consecutive patients (8 women, 2 men; mean age, 30 years) were studied. There were four superficial fissures, four cavitating ulcers, six low or superficial fistulas, two high fistulas, and one irreversible anal stenosis. All patients had received one or more medical treatments without healing the perineal lesions, and all had had previous surgery for perineal lesions.


RESULTS
Two patients discontinued HBO after a few sessions and did not complete treatment. Eight patients completed at least 30 HBO sessions and were evaluable. At the end of the procedure, six of eight patients treated were healed, three completely and three partially. All patients who healed completely received HBO as an additional treatment to local perineal surgery.


CONCLUSIONS
HBO might be useful as a last resort treatment of chronic perineal Crohn's disease, resistant to other treatments or as a complement to surgery.
Colombel
J F
JF
Clinique des Maladies de l'Appareil Digestif et de la Nutrition, Hôpital Huriez, CHRU Lille, France.
Mathieu
D
D
Bouault
J M
JM
Lesage
X
X
Zavadil
P
P
Quandalle
P
P
Cortot
A
A
D000328:Adult; D003131:Combined Modality Therapy; D003424:Crohn Disease / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D005260:Female; D006801:Humans; D006931:Hyperbaric Oxygenation; D008297:Male; D010502:Perineum / Q000473:pathology*