Perirectal Abscess-Reply FREE

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