True statement regarding anorectal Crohn's disease:: (A) Ulceration, fistula is common, (B) Fistulas are painless and indurated, (C) Non-cutting setons are used in management, (D) All of the above
Answer is D. CROHN'S DISEASE OF THE ANORECTUM Typically presents in three ways: Ulceration (MC), fistula and stricture. Fistulas tend to be chronic, indurated, and cyanotic and are often painless. Abscesses need to be drained and fistula tracts require chronic drainage with non-cutting setons. Once the perianal sepsis is controlled, infliximab treatment is initiated. After two or three infliximab infusions, the setons are removed to permit closure of the fistulas.