Outcome of perianal fistulae in Crohn's disease —value of Hughes' pathogenic classification

Applying the Hughes' pathogenic classification of anoperineal lesions of Crohn's disease, this study was conducted to find out its possible prognostic value in perianal fistulas. Thirty-eight patients with ano-perianal fistulas were included; primary specific lesions (condyloma, cavitating ulcer, fissure) were found in 22 patients (group 1) and were absent in the other 16 patients (group 2). Patients of group 1 underwent more abdominal surgical interventions (G1: 68%; G2: 31%-P=0.05), as well as proctological interventions (G1: 2.95 operations/patient vs 1.35 in G2-P=0.01). Perfect continence was recorded ultimately in 31.8% patients of G1 compared to 62.5% of G2. This study shows the very poor prognosis of ano-perianal fistulas in Crohn's disease.