What is the role of a seton in the management of Crohn disease?

Updated: Jul 26, 2019
  • Author: Leyla J Ghazi, MD; Chief Editor: Praveen K Roy, MD, AGAF  more...
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Answer

True abscess requires drainage. When a fistula tract can be identified, a seton can be used to prevent premature skin closure and recurrent abscesses. These indwelling setons should be left in place for an extended period (up to 6-12 months) to allow complete epithelialization of the tract as visualized by MRI or EUS. This approach leads to a chronically draining fistula tract. In cases where severe perianal disease has destroyed the sphincter, proctectomy with permanent ileostomy may be necessary. [80, 138, 139, 140]


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