Polyfistulous Perineum: What is the Contribution of Colonoscopy to the Etiological Workup?

Polyfistulous perineum is a rare but indicative clinical manifestation of several chronic digestive disorders, particularly Crohn’s disease and intestinal tuberculosis. Colonoscopy, especially when it includes exploration of the terminal ileum, plays a crucial role in the etiological diagnosis of this condition. This retrospective study, conducted on 32 patients presenting with a polyfistulous perineum, aimed to assess the contribution of colonoscopy in identifying associated digestive lesions. Endoscopic abnormalities were found in nearly 59% of cases, guiding the diagnosis towards Crohn’s disease in more than half of them, followed by ileocolic tuberculosis. These findings highlight the importance of colonoscopy as a first-line tool in the diagnostic evaluation of polyfistulous perineum, enabling the initiation of specific and early management.