naa a22 4500 510814042 CHVBK 20180411083456.0 cr unu---uuuuu 180411e20130801xx s 000 0 eng 10.1007/s12328-013-0404-z doi (NATIONALLICENCE)springer-10.1007/s12328-013-0404-z Anorectal fistula is an early manifestation of Crohn's disease that occurs before bowel lesions advance: a study of 11 cases [Elektronische Daten] [Naoto Saigusa, Tadashi Yokoyama, Masaru Shinozaki, Ryoji Miyahara, Tsuyoshi Konishi, Toshio Nakamura, Yasuhisa Yokoyama] The diagnostic significance of single-balloon enteroscopy (SBE) in patients presenting with Crohn's disease (CD)-like anorectal fistula is unknown. We experienced 11 cases undergoing SBE due to CD-like fistulas between December 2007 and April 2013. The mean interval from fistula onset to SBE was 19.2months with a range of 1.3−44.7. Prior to SBE, all patients underwent anorectal examination under anesthesia (EUA), and 9 patients underwent total colonoscopy with terminal ileal cannulation (TCS-I). One of 7 patients undergoing upper gastrointestinal endoscopy had CD-like gastritis. EUA revealed CD fissures in 7 patients, 1 of whom had no intestinal lesion. Primary TCS-I identified early lesions, such as aphthes and small ulcers, in 4 patients. Among the other 5 patients without any intestinal lesions with TCS-I, SBE indicated early lesions in 3 patients. One of 2 patients who initially underwent SBE without TCS-I showed multiple aphthes. Of the 11 patients, only 4 patients fulfilled the definitive Japanese diagnostic criteria for CD and 7 remained ‘suspected CD' cases. Intrinsic anorectal fistulas as a presenting symptom of CD may be an early predictor of bowel lesions. SBE has the potential to reveal incipient disease because an early ileal lesion is not rare for patients with anorectal fistulas. Springer Japan, 2013 Crohn's disease nationallicence Anorectal fistula nationallicence Balloon enteroscopy nationallicence Early lesions nationallicence Saigusa Naoto Department of Surgery, Yokoyama Hospital for Gastroenterological Diseases, 3-11-20 Chiyoda, Naka-ku, 460-0012, Nagoya, Japan aut Yokoyama Tadashi Department of Surgery, Yokoyama Hospital for Gastroenterological Diseases, 3-11-20 Chiyoda, Naka-ku, 460-0012, Nagoya, Japan aut Shinozaki Masaru Department of Surgery, Research Hospital, Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, 108-8639, Tokyo, Japan aut Miyahara Ryoji Department of Gastroenterology and Hepatology, Nagoya University, Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, 466-8560, Nagoya, Aichi, Japan aut Konishi Tsuyoshi Department of Surgery, Gastroenterology Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, 135-8550, Tokyo, Japan aut Nakamura Toshio Department of Surgery, Fujieda Municipal General Hospital, 4-1-11 Surugadai, 426-8677, Fujieda, Japan aut Yokoyama Yasuhisa Department of Surgery, Yokoyama Hospital for Gastroenterological Diseases, 3-11-20 Chiyoda, Naka-ku, 460-0012, Nagoya, Japan aut Clinical Journal of Gastroenterology Springer Japan 6/4(2013-08-01), 309-314 1865-7257 6:4<309 2013 6 12328 https://doi.org/10.1007/s12328-013-0404-z text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12328-013-0404-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Saigusa Naoto Department of Surgery, Yokoyama Hospital for Gastroenterological Diseases, 3-11-20 Chiyoda, Naka-ku, 460-0012, Nagoya, Japan aut NATIONALLICENCE 700 1- Yokoyama Tadashi Department of Surgery, Yokoyama Hospital for Gastroenterological Diseases, 3-11-20 Chiyoda, Naka-ku, 460-0012, Nagoya, Japan aut NATIONALLICENCE 700 1- Shinozaki Masaru Department of Surgery, Research Hospital, Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, 108-8639, Tokyo, Japan aut NATIONALLICENCE 700 1- Miyahara Ryoji Department of Gastroenterology and Hepatology, Nagoya University, Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, 466-8560, Nagoya, Aichi, Japan aut NATIONALLICENCE 700 1- Konishi Tsuyoshi Department of Surgery, Gastroenterology Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, 135-8550, Tokyo, Japan aut NATIONALLICENCE 700 1- Nakamura Toshio Department of Surgery, Fujieda Municipal General Hospital, 4-1-11 Surugadai, 426-8677, Fujieda, Japan aut NATIONALLICENCE 700 1- Yokoyama Yasuhisa Department of Surgery, Yokoyama Hospital for Gastroenterological Diseases, 3-11-20 Chiyoda, Naka-ku, 460-0012, Nagoya, Japan aut NATIONALLICENCE 773 0- Clinical Journal of Gastroenterology Springer Japan 6/4(2013-08-01), 309-314 1865-7257 6:4<309 2013 6 12328 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer