A 65-year-old man with Crohn’s disease presents with intermittent bleeding from a long-standing anal fistula. He is on infliximab with good endoscopic control. On examination, there are large skin tags and an external fistula opening with irregular, heaped up, and friable edges. There is no evidence of abscess. Which of the following would be the most appropriate next step?
There's more to see -- the rest of this topic is available only to subscribers.