Research advances in diagnosis and treatment of Crohn’s disease presenting with perianal fistula as the initial symptom

Perianal fistula is one of the common perianal manifestations of Crohn’s disease, with approximately 10% of patients presenting with perianal fistula as the initial symptom, often leading to delayed diagnosis due to the absence of typical gastrointestinal symptoms. Clinical diagnosis and treatment are facing many challenges due to currently limited relevant studies on Crohn’s disease with perianal fistula as the initial manifestation. Refining the early identification and evaluation system for Crohn’s disease presenting with perianal fistula as the initial symptom, along with formulating individualized therapeutic regimens, holds critical clinical significance as a reference paradigm.