Dr. G.S. Raju, editor of the Gastro Grand Rounds section in Gastroenterology, is joined by Dr. David Ballard and Dr. Parakkal Deepak to discuss their Gastro Grand Rounds article, "Long-Standing Symptomatic Fistulizing Perianal Crohn’s Disease: Progression Beyond Inflammation."

https://www.gastrojournal.org/article/S0016-5085(23)04997-1/fulltext

Dr. Ballard is an assistant professor of radiology and director of the 3D Printing Lab at the Mallinckrodt Institute of Radiology at Washington University School of Medicine in St. Louis.

Dr. Deepak is an Associate Professor of Medicine in the Division of Gastroenterology at Washington University School of Medicine in St. Louis.

[0:27] Introduction of the authors and outline of the case.

[2:29] What initial steps does a gastroenterologist take to manage a patient who presents with possible perianal Crohn’s disease?

[6:47] How does an imaging specialist plan for imaging of the perianal disease, and what techniques are used in support of the endoscopist or gastroenterologist?

[11:33] The role of point-of-care ultrasound in perianal disease.

[15:38] When is a colorectal surgeon brought on board, and what does a colorectal surgeon do when examining the patient?

[19:57] How does the clinician manage abscess and fistula?

[25:13] Are there any radiological signs that indicate that a particular fistula may be particularly difficult to manage?

[29:38] What is a standard treatment for perianal fistula that evolves to cancer?

[31:27] Did the patient notice a change in the nature of the discharge?

[32:35] Final thoughts from the authors.

Thank you for listening. Find this and other articles on our website at https://www.gastrojournal.org. We welcome your feedback. Please email us at gastro@gastro.org.

This discussion was recorded on Nov. 1, 2023, and reflects medical knowledge at that time. The views and opinions expressed in this podcast are those of the individual speakers only and do not necessarily represent those of the American Gastroenterological Association. The content of this podcast is provided for general information purposes only and does not offer medical or any other type of professional advice.