In Reply.—We share Dr Grand's concern that cases of inflammatory bowel disease with perirectal abscess not be overlooked. Although our follow-up of patients since 1965 may not be complete, none of our patients are known to have inflammatory bowel disease subsequently develop. Similarly, none of the pediatric patients of Enberg et al1 were reported as having underlying inflammatory bowel disease. It seems possible that Dr Grand in practicing at a tertiary care institution may be seeing a somewhat different group of patients with perirectal disease than that described in our study. We agree with Schrock2 that any patient with perianal disease and other symptoms consistent with inflammatory bowel disease such as chronic diarrhea, weight loss, or abdominal pain or extra-gastrointestinal signs and symptoms such as refractory anemia, arthritis, iritis, or skin rash should be elevated fully for the presence of inflammatory bowel disease.2
CHUSID MJ, KRIEGER RW. Perirectal Abscess-Reply. Am J Dis Child. 1979;133(11):1203–1204. doi:10.1001/archpedi.1979.02130110111030
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