What are the possible complications of pediatric Crohn disease and how are they evaluated?

Updated: Oct 23, 2018
  • Author: Andrew B Grossman, MD; Chief Editor: Carmen Cuffari, MD  more...
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Answer

Fistula and abscess formation is common in Crohn disease and is due to transmural bowel perforation. Perianal and perirectal fistulization are most common. Proper evaluation of perianal disease requires a combination of 2 of the following:

  • Pelvic magnetic resonance imaging (MRI)

  • Examination under anesthesia

  • Endoscopic ultrasonography

Other complications of fistulizing disease include enterovesical and enterocutaneous fistulas.

A study by Herman et al aimed to assess phenotypic features at diagnosis and long-term disease-specific outcomes in 296 children perianal Crohn's disease reported that fistulizing and nonfistulizing perianal disease was associated with worse outcomes. The study also reported that the presence of nonfistulizing disease at diagnosis was a significant risk factor for the development of fistulizing perianal disease (HR 3.4, P = 0.002) and that females were more associated with perianal involvement (P = 0.01). [35]


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