What kind of fistula is associated with perianal Crohn's disease?

Hi,

Are there particular fistulas that are associated with perianal Crohn's disease? I was diagnosed over a year ago with a perianal abscess that developed into a perianal fistula.

Ten months ago I had a pelvic MRI which showed a perianal fistula, "approximately 5cm above the anal verge, arising at 4 o'clock from the left posterior aspect and coursing laterally through the left levator ani, then branching into superior and inferior tracts. The superior tract extends anteriorly and superiorly for ~1cm, ending blindly just lateral to the puborectalis. The inferior tract courses laterally to the external sphincter through the left ischiorectal and ischioanal fossa, exiting the left intergluteal cleft. There is adjacent extensive soft tissue enhancement."

At the time, the colorectal surgeon speculated it could be a transphincteric or suprasphincteric complex perianal fistula.

Five months ago, I had a fistulotomy with seton placement. The CRS was able to do partial surgery since the fistula was very deep. I don't know what kind of fistula it turned out to be.

To complicate things, my seton fell out about a month ago. I''ll following-up wth the CRS to determine my next course of action.

My gastroenterologist thought I had perianal Crohn's disease, however, he told me recently a firm diagnosis couldn't be made. He mentioned that the fistula was less common in perianal Crohn's disease, but he didn't tell me what kind of fistula it was.

Thank you for your help!

Hi Gidget,

Do you have other symptoms of Crohn's aside from the fistula? That would be the main concern and reason to have a colonoscopy if you haven't already.