Operative management of Crohn's disease of the colon including anorectal disease

Inflammatory bowel disease (IBD) is an idiopathic, ulcerogenic, inflammatory condition of the gastrointestinal tract, including Crohn's disease and ulcerative colitis. Despite being included under the broad umbrella of IBD, Crohn's disease differs distinctly from ulcerative colitis. Because Crohn's disease occurs anywhere along the alimentary tract from the mouth to the anus and is marked by multiple recurrences, surgical excision is not a curative procedure. In fact, up to 90% of patients require at least one operation during their lifetime [1]. The surgeon must then not only take into account the appropriate treatment of the acute problem at hand but also balance the ramifications of that therapy with potential future exacerbations in what is most often a palliative procedure. Surgeons therefore need to be exceedingly aware of the indications, surgical options, and expected outcomes for the patient who has Crohn's disease. Furthermore, although the precise cause of the disease remains unknown, our understanding of the principles guiding surgical treatment has expanded greatly and continues to evolve.