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Colorectal Diseases

Perianal fistulas

05/09/2008

Question:

I have perianal fistulas due to Crohn`s with one internal opening and three external openings. Three Setons are in place now. My colorectal surgeon said that is very unusual to have three external openings going to only one internal opening.

Why is that so unusual?

I would imagine having only one internal opening and three external openings has a better chance of closing and staying closed never to return once I start on Remicade treatments. Is my logic about this correct?

Thank you.

Answer:

This is not unusual in the setting of Crohn's disease. Your success with Remicade is determined by whether or not the inflammation resolves, not necessarily the number of openings. Good luck!

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Response by:

Janice Frederick Rafferty, MD Janice Frederick Rafferty, MD
Professor of Surgery
Chief of Colorectal Surgery Division
College of Medicine
University of Cincinnati