Study to Look at Benefit of Surgical Drainage Before Beginning Medical Therapy for Crohns Perianal Fistulas

Inclusion Criteria: * Male and Female aged 18 years or older; * A confirmed diagnosis of Crohn's disease and one or more identifiable perianal fistulas; * Patient's standard of care treatment plan includes the following options: a) surgical intervention with an exam under anesthesia (EUA) by colorectal surgeon, seton placement and drainage of fistula prior to initiating Certolizumab or b) initiating Certolizumab without surgical intervention; * Patient has had recent colonoscopy to determine disease activity and extent; and * Patient has had either rectal EUS or pelvic MRI (type of test based on investigator site preference) which has identified one or more perianal fistulas. Exclusion Criteria: * Any of Inclusion Criteria is not met; * Females who are pregnant or breast feeding; * Anti-TNF use within 6 weeks prior to study entry; * Patients who cannot take, or refuse to take concomitant immunosuppressive therapy with either azathioprine, 6-mercaptopurine, or methotrexate; Unless patient has been intolerant of these therapies in the past or is contraindicated as determined by the investigator. * Patients who cannot take, or refuse to take concomitant antibiotic therapy; * Patients with severe anal stenosis or tenderness which would preclude colonoscopy and / or rectal EUS; * Patients who cannot take or refuse to take certolizumab; * Patients with active or latent tuberculosis; * Patients who have had systemic antibiotic, antiviral or antifungal treatment(s) within 3 weeks …