Fistulizing Crohn's Disease Presenting After Surgery on a Perianal Lesion

Perianal skin lesions, such as skin tags, can be an early presenting sign of Crohn's disease. Surgical intervention on these lesions may increase the risk of fistula development and lead to worse outcomes. This case series examined 8 patients who underwent surgical intervention on what appeared...

Full description

Saved in:
Bibliographic Details
Published inPediatrics (Evanston) Vol. 137; no. 3; p. e20152878
Main Authors Singer, Andrew A M, Gadepalli, Samir K, Eder, Sally J, Adler, Jeremy
Format Journal Article
LanguageEnglish
Published United States 01.03.2016
Subjects
Online AccessGet more information

Cover

Loading…
Abstract Perianal skin lesions, such as skin tags, can be an early presenting sign of Crohn's disease. Surgical intervention on these lesions may increase the risk of fistula development and lead to worse outcomes. This case series examined 8 patients who underwent surgical intervention on what appeared to be benign perianal skin lesions, only to reveal fistulas leading to the diagnosis of Crohn's disease. This patient population comprised 20% of all pediatric patients with Crohn's disease who had perianal fistula present at diagnosis. The initial type of perianal lesion varied from case to case and included skin tags, hemorrhoids, and perianal abscesses. All of the patients had other presenting features that, in retrospect, may have been attributed to Crohn's disease. None presented solely with a perianal lesion. Four patients had weight loss or growth failure. Most of the remainder had abnormal laboratory test results. These findings should raise the awareness of primary care providers that perianal lesions can be the first presenting sign of possible Crohn's disease in otherwise healthy appearing children. Such children should undergo a thorough evaluation for Crohn's disease before surgical intervention on perianal lesions because surgical procedures may be associated with worse outcomes.
AbstractList Perianal skin lesions, such as skin tags, can be an early presenting sign of Crohn's disease. Surgical intervention on these lesions may increase the risk of fistula development and lead to worse outcomes. This case series examined 8 patients who underwent surgical intervention on what appeared to be benign perianal skin lesions, only to reveal fistulas leading to the diagnosis of Crohn's disease. This patient population comprised 20% of all pediatric patients with Crohn's disease who had perianal fistula present at diagnosis. The initial type of perianal lesion varied from case to case and included skin tags, hemorrhoids, and perianal abscesses. All of the patients had other presenting features that, in retrospect, may have been attributed to Crohn's disease. None presented solely with a perianal lesion. Four patients had weight loss or growth failure. Most of the remainder had abnormal laboratory test results. These findings should raise the awareness of primary care providers that perianal lesions can be the first presenting sign of possible Crohn's disease in otherwise healthy appearing children. Such children should undergo a thorough evaluation for Crohn's disease before surgical intervention on perianal lesions because surgical procedures may be associated with worse outcomes.
Author Eder, Sally J
Adler, Jeremy
Gadepalli, Samir K
Singer, Andrew A M
Author_xml – sequence: 1
  givenname: Andrew A M
  surname: Singer
  fullname: Singer, Andrew A M
  email: jeradler@med.umich.edu
  organization: Department of Pediatrics and Communicable Diseases, Division of Pediatric Gastroenterology, jeradler@med.umich.edu
– sequence: 2
  givenname: Samir K
  surname: Gadepalli
  fullname: Gadepalli, Samir K
  organization: Department of Surgery, Division of Pediatric Surgery, and Children's Health Evaluation and Research Unit, University of Michigan, Ann Arbor, Michigan
– sequence: 3
  givenname: Sally J
  surname: Eder
  fullname: Eder, Sally J
  organization: Children's Health Evaluation and Research Unit, University of Michigan, Ann Arbor, Michigan
– sequence: 4
  givenname: Jeremy
  surname: Adler
  fullname: Adler, Jeremy
  organization: Department of Pediatrics and Communicable Diseases, Division of Pediatric Gastroenterology, Children's Health Evaluation and Research Unit, University of Michigan, Ann Arbor, Michigan
BackLink https://www.ncbi.nlm.nih.gov/pubmed/26908665$$D View this record in MEDLINE/PubMed
BookMark eNo1j81LwzAcQIMo7kOvHiU3T53JLx9Nj6M6HRQcqOeRNr_OSJeWpD3Mv15EPb3DgwdvQc5DH5CQG85WXEm4H9ClFTCuMjC5OSNzzgqTScjVjCxS-mSMSZXDJZmBLpjRWs3JduPTOHX-y4cDLWP_Ee4SffAJbUK6i5gwjD9q3Y4Y6esUDxhPtA_U0h1Gb4PtaIXJ9-GKXLS2S3j9xyV53zy-lc9Z9fK0LddV1ggtxkwYy62skXFhheFt20BT5E43RhXKSQRl29oAcBSYg7bKYFtrx8Ghk0xbWJLb3-4w1Ud0-yH6o42n_f8TfANzjk6j
CitedBy_id crossref_primary_10_1371_journal_pone_0219893
crossref_primary_10_1001_jamanetworkopen_2020_7378
crossref_primary_10_1097_MPG_0000000000001649
crossref_primary_10_1080_14712598_2020_1718096
crossref_primary_10_1186_s12876_021_01961_9
crossref_primary_10_1016_j_cgh_2019_07_038
crossref_primary_10_1016_j_sempedsurg_2024_151402
crossref_primary_10_1097_MPG_0000000000001447
crossref_primary_10_1016_j_yapd_2021_05_005
crossref_primary_10_14366_usg_22057
crossref_primary_10_1016_j_cgh_2020_04_060
crossref_primary_10_1097_MPG_0000000000003595
crossref_primary_10_1002_ccr3_8963
crossref_primary_10_1055_s_0040_1716724
ContentType Journal Article
Copyright Copyright © 2016 by the American Academy of Pediatrics.
Copyright_xml – notice: Copyright © 2016 by the American Academy of Pediatrics.
DBID CGR
CUY
CVF
ECM
EIF
NPM
DOI 10.1542/peds.2015-2878
DatabaseName Medline
MEDLINE
MEDLINE (Ovid)
MEDLINE
MEDLINE
PubMed
DatabaseTitle MEDLINE
Medline Complete
MEDLINE with Full Text
PubMed
MEDLINE (Ovid)
DatabaseTitleList MEDLINE
Database_xml – sequence: 1
  dbid: NPM
  name: PubMed
  url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
  sourceTypes: Index Database
– sequence: 2
  dbid: EIF
  name: MEDLINE
  url: https://proxy.k.utb.cz/login?url=https://www.webofscience.com/wos/medline/basic-search
  sourceTypes: Index Database
DeliveryMethod no_fulltext_linktorsrc
Discipline Medicine
EISSN 1098-4275
ExternalDocumentID 26908665
Genre Journal Article
Case Reports
GroupedDBID ---
-ET
..I
.55
.GJ
0R~
123
18M
1CY
1HT
26-
29O
2KS
2QL
2WC
36B
39C
4.4
41~
53G
5RE
5VS
6PF
7K8
85S
8F7
8GL
96U
AAAMJ
AAHTB
AAIKC
AAJMC
AAKAS
AAMNW
AAQOH
AAWTL
AAWTO
AAYOK
ABCZD
ABIVO
ABJNI
ABOCM
ABPEJ
ABPPZ
ACBMB
ACGFO
ACGOD
ACNCT
ACPRK
ADCOW
ADZCM
AENEX
AFAZI
AFFNX
AFHKK
AFOSN
AFRAH
AGFXO
AHMBA
AJUXI
ALMA_UNASSIGNED_HOLDINGS
BKOMP
CGR
CS3
CUY
CVF
DIK
DU5
E3Z
EBS
ECM
EIF
EJD
ESX
EX3
F5P
F8P
FEDTE
GICCO
GOZPB
GX1
H13
HF~
HVGLF
IAG
IAO
ICJ
IEA
IER
IGG
IHR
IHW
IMI
INH
INR
IOF
IPO
IPY
ISE
ITC
IVC
KO8
KQ8
L7B
LXL
LXN
LXY
N4W
N9A
NEJ
NPM
OHT
OK1
OMK
OVD
P0W
P2P
PDE
PQQKQ
Q.-
RHF
RHI
SJN
TAE
TEORI
TR2
TWZ
UBE
UHB
UMD
W8F
WH7
WHG
WOQ
WOW
WQ9
X7M
XJT
XOL
XZL
YCJ
YHG
YHZ
YOC
YQI
YQJ
YZZ
ZGI
ZRR
ZXP
~KM
~X8
ID FETCH-LOGICAL-c363t-38a1a4be013a381ffc2c97d6c8595d4e25afb8221e3e726a58efb6d12ded406a2
IngestDate Tue Aug 27 13:48:33 EDT 2024
IsDoiOpenAccess false
IsOpenAccess true
IsPeerReviewed true
IsScholarly true
Issue 3
Language English
License Copyright © 2016 by the American Academy of Pediatrics.
LinkModel OpenURL
MergedId FETCHMERGED-LOGICAL-c363t-38a1a4be013a381ffc2c97d6c8595d4e25afb8221e3e726a58efb6d12ded406a2
OpenAccessLink https://pediatrics.aappublications.org/content/pediatrics/137/3/e20152878.full.pdf
PMID 26908665
ParticipantIDs pubmed_primary_26908665
PublicationCentury 2000
PublicationDate 2016-Mar
PublicationDateYYYYMMDD 2016-03-01
PublicationDate_xml – month: 03
  year: 2016
  text: 2016-Mar
PublicationDecade 2010
PublicationPlace United States
PublicationPlace_xml – name: United States
PublicationTitle Pediatrics (Evanston)
PublicationTitleAlternate Pediatrics
PublicationYear 2016
SSID ssj0004572
Score 2.3463817
Snippet Perianal skin lesions, such as skin tags, can be an early presenting sign of Crohn's disease. Surgical intervention on these lesions may increase the risk of...
SourceID pubmed
SourceType Index Database
StartPage e20152878
SubjectTerms Adolescent
Anal Canal - pathology
Biopsy
Child
Crohn Disease - surgery
Digestive System Surgical Procedures - adverse effects
Female
Follow-Up Studies
Humans
Male
Postoperative Complications
Rectal Fistula - diagnosis
Rectal Fistula - etiology
Retrospective Studies
Title Fistulizing Crohn's Disease Presenting After Surgery on a Perianal Lesion
URI https://www.ncbi.nlm.nih.gov/pubmed/26908665
Volume 137
hasFullText
inHoldings 1
isFullTextHit
isPrint
link http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1LS8NAEF6qgngR32_Zg-Ap2myym-2xaIsK7aUt9FY2uxsU-qKtB4s_3tlHk1oUH5dQsmkI-33ZzMzOfIPQFXhbVHGX50eCmCYiqDBJAyqyimSKK1I2Bc6NJnvoxE9d2i2V3perS2bpjZx_WVfyH1ThHOBqqmT_gGx-UzgBvwFfOALCcPwVxnXA6LX_Mrd795PRs2uPcu_2XGx2hXaNIKq2E3jLlUCb_QFhUt-BGSaMracLbLyRmrfvsBFZa2tbCzGPGbRsLLDIh4TVpRDaFwq-cH1Xdd0Sg5dJEUmtKd_mC8bfig0pkyswcak2E-0rLHwgImRFJtaNdoun0SaNieuEkq-uTtPF0yhaWis13ISCw8a_XMlpbJRhx1oZTfWQBqsXAhLjgcWVgINvVPt-Hl1R1l4MraG1hJu2H00T6cmV5hPiRT7hUW4_P4iRkPZ_XnFHrFnS3kHb3p_AVUeOXVTSwz202fAZE_vocYkj2HLkeoo9Q3DBEGwZgj1D8GiIBV4wBDuGHKBOvda-ewh8-4xARiyaBREXoYhTDUa-ALssyySRlUQxaSTtVKwJvI8p2IehjnRCmKBcZylTIVFagZknyCFaH46G-hhhzpUsV2BKsiyO4dOaCkIlJzpkZakSUj5BR24SemOnkdJbTM_ptyNnaKtg0TnayOCl1Bdg4c3SSwvFB1jTTdM
link.rule.ids 780
linkProvider National Library of Medicine
openUrl ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Fistulizing+Crohn%27s+Disease+Presenting+After+Surgery+on+a+Perianal+Lesion&rft.jtitle=Pediatrics+%28Evanston%29&rft.au=Singer%2C+Andrew+A+M&rft.au=Gadepalli%2C+Samir+K&rft.au=Eder%2C+Sally+J&rft.au=Adler%2C+Jeremy&rft.date=2016-03-01&rft.eissn=1098-4275&rft.volume=137&rft.issue=3&rft.spage=e20152878&rft_id=info:doi/10.1542%2Fpeds.2015-2878&rft_id=info%3Apmid%2F26908665&rft_id=info%3Apmid%2F26908665&rft.externalDocID=26908665