[Preserving continence in treatment of inflammatory bowel disease associated anal fistulas].

An overview of frequency, diagnosis, classification and therapy of perianal fistula in Crohn's disease is presented. There is a positive correlation with the extent of intestinal disease. The fistula as primary manifestation can present problems of differential diagnosis. Crohn fistulas may persist for an extended period of time without discomfort and complaints. Surgical treatment should be individualized for any given form of fistula. Hemorrhoidectomy in Crohn's disease associated with perianal fistulas should be avoided. Transspincteric and recto-vaginal fistulas can be treated by peranal mucosal flap with good results. In summary, neither therapeutic nihilism nor hyperactivity is justified.