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Summary Any gastroenterologist must be trained to properly diagnose anoperineal lesions in patients with Crohn's disease (APLOC). The aim of this study was to establish whether adding pictures would improve teaching effectiveness of the diagnosis of APLOC to French gastroenterology trainees. Method Trainees were asked to answer a first web-based survey consisting of evaluating 12 pictures of APLOC with a closed answer questionnaire. They were then randomized in 2 groups. Group A received an online teaching with typical pictures and APLOC definitions and group B definitions only. Trainees were asked again seven days later to answer a second survey with 12 other pictures of APLOC and 14 experts also answered this survey. Diagnostic scores were expressed in %. The primary endpoint was the comparison of the score of survey 2 between the two groups of trainees. Secondary endpoints were to compare results of survey 2 between trainees of both groups and experts, and assess diagnosis of each lesion. Results Two hundred fourty eight trainees among 465 answered survey 1, and 195 survey 2. The diagnostic score was 71.9% for groups A and B and 74.6% for experts (differences NS). After training diagnosis of ulceration was 72% for group A and 72.9% for group B, fistulae 85.2% versus 85.8%, erythema 44.1% vs. 55.6%, anoperineal scars 67.5% vs. 65.6%, and abscess 100% (differences NS). Conclusion There was no difference between the two teaching methods. Further research should be performed aiming at improving teaching material and quotation baremes.

La prise en charge des troubles de la statique pelvienne est une entreprise difficile. L'objectif a atteindre n'est pas de restituer une anatomie normale mais de diminuer les symptomes fonctionnels sans decompenser ou reveler un incontinence anale ou urinaire. L'examen clinique sera le plus souvent suffisant avant de proposer un traitement medical. En revanche, avant la decision d'un traitement chirurgical, un bilan lesionnel complet des differents etages du perinee devra etre realise afin de guider le chirurgien dans le choix de la technique operatoire et d'en limiter les eventuels effets secondaires.