Crohn Disease Has Been in Medicine / Internal Medicine — 28yo Man | Gastroenterology | SMLE Q#18142
SMLE Question #18142
Medicine / Internal Medicine
Gastroenterology
Objective: OBJ-IM-GI-214
Last updated: February 2026
A 28-year-old man with Crohn disease has been taking mesalazine for 3 months with good control of abdominal symptoms. For 3 weeks, he has had perineal pain and purulent discharge. Examination shows two external perianal openings with minimal drainage and no fluctuance or marked tenderness. Pelvic MRI shows perianal fistula tracts without a drainable abscess. What is the most appropriate next step in management?
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