Fistulating Anal Crohnʼs Disease: Results of Combined Surgical and Infliximab Treatment

INTRODUCTION: METHODS: RESULTS:Twenty-two patients underwent infliximab treatment (6 males; median age, 35 (range, 16-60) years). Twenty-one patients had preinfliximab examination under anesthesia12 required abscess drainage; 17 had at least one drainage seton suture inserted. Fourteen patients underwent pretreatment magnetic resonance imaging to identify clinically occult collections. All but one patient were established on immunomodulator therapy before infliximab treatment. Perianal Crohnʼs disease activity index improved significantly after infliximab infusion (preinfusionmedian, 11, range, 8-17; postinfusionmedian, 8, range, 5-16; P< 0.001). There were no serious complications of infliximab treatment. At median follow-up of 21 (range, 4-31) months, only four patients achieved sustained fistula healing. Five patients have required defunctioning or proctectomy. Four patients have required repeated infusions of infliximab. CONCLUSIONS: