Surgical perspective on perianal complications in ulcerative colitis

Perianal disease (PD) in Inflammatory Bowel Diseases (IBD) is typically associated with Crohn's disease (CD). In fact, the presence of PD, even in an established diagnosis of Ulcerative Colitis (UC), always rises in the clinician's mind the suspect of CD. However, historical series of UC patients from the 1950s and the 1960s reported an incidence of PD in the range of 20-25 %. These rates, of course, were misleading, since colonic CD and Indeterminate Colitis (IC) were first recognized in the 1960s and 1970s, respectively. Certainly, many patients supposed in the past to have UC and PD really had CD or IC, but to date, little is known about the real incidence of PD among UC patients that is considered to be of about 5-15 % [1-13].