Anal Crohn's Disease

Background: Anal lesions as first manifestation of Crohn's disease can cause difficulties in differential diagnosis especially, when morphologic intestinal changes and, histologically, epitheloid granulomas cannot be demonstrated early. Case Reports: We present a 19-year-old femal patient with atypical anal fissures and a 76-year-old male patient with a circular anal stenosis leading to the diagnosis Crohn's disease which could be proved later. Conclusion: In case of anal fissures or ulcerations Crohn's disease has to be considered, also when endoscopic preexaminations had excluded morphologic equivalents of this disease. We would like to stress that in these cases a repetition of such invasive diagnostic features can be necessary.