The development of fistulae in Crohn’s disease is as a rule considered a complication of the disease, although it may be a possible part of the natural development of so-called type A (DeDombal’s classification) or the aggressive perforating type (Greenstein’s classification) of this idiopathic inflammation of the gut. Fistulae are associated in 20% with a colonic localization of Crohn’s disease and in 40% an ileocolonic affection whereby 35% are perianal fistulae and ca 34% entero-enteral or enterocutaneous fistulae. Further communications (into the urogenital tract, biliary tract)are rarely reported in the literature. A dominant position in treatment in addition to surgical approaches is held in the sphere of conservative therapy by the anti-tumour necrotizing factor, antibiotics and immunosuppressive agents. Their position is, however, relatively most problematic although references in the literature on the effectiveness of azathioprin, 6-mercaptopurine, cyclosporin, tacrolim and methotrexate have a tradition of almost a quarter of a century. The authors submit their own experience from 1995–2000 with a combination of cyclosporin-azathioprin in the treatment of perianal fistulae in a group of 21 patients. The success of treatment is according to them limited in particular by early onset of therapy (11 cases of effective treatment) and the selection of an energetic procedure, represented in their opinion also by sequence immunosuppression.

        Key words: IBD (idiopathic inflammations of the gut) – CD (Crohn’s disease) – CyA (cyclosporin A) – CDAI (Crohn’s disease Activity Index [Best])