Perianal Fistulizing Crohn's disease: imaging modalities and therapeutic challenges
Perianal involvement in Crohn's disease is not infrequent. Risk factors for the development of fistulas include a high activity of CD, a fibrostenotic phenotype, genetic markers such as the HLA-DRB1 allele and certain mutations of the genes including NOD2. In perianal CD the treatment should be multidisciplinary. The best outcomes have been achieved when medical and surgical therapies-if needed- are used in conjunction. Therapy of perianal fistulizing CD traditionally includes the use of immunosuppressants and has been significantly modified after the introduction of biologicals.