Clinical characteristics and treatment of perianal abscess and fistula-in-ano in infants

Chang, Hye Kyung; Ryu, Je Gyu; Oh, Jung Tak

doi:10.1016/j.jpedsurg.2010.03.021

Cited by 28 publications

(28 citation statements)

References 21 publications

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“…However, many reviews have reported no recurrence of FIA after either fistulotomy or fistulectomy [1,14,19]. Novotny et al [13] reported that recurrence is more likely in older children and in children who had previous episodes of PAA or if pus was noted at the time of surgery.…”

Section: Discussionmentioning

confidence: 99%

Fistulotomy versus fistulectomy as a treatment for low anal fistula in infants

Gafar¹

2013

Annals of Pediatric Surgery

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Objective To compare between two methods of surgical treatment for fistula-in-ano (FIA) in infants, fistulotomy and fistulectomy, and their surgical outcome and also to review the clinical presentation and diagnosis of this condition in our tertiary center.Background FIA occurring in infants is a relatively common condition. It is more common in boys than in girls, and 96% of cases occur in infants younger than 1 year. The surgical treatment options of these fistulas are fistulotomy or fistulectomy.Patients and methods In this study, between January 2010 and December 2011, 36 infants with low-type FIA were treated surgically. Eighteen infants were treated by fistulotomy (group A) and 18 were treated by fistulectomy (group B). No infant had underlying illness. All cases were subjected to the same protocol of preoperative evaluation, anesthesia, and follow-up protocol. The two techniques were compared in terms of the operative time, healing time, complications, and outcome. All were reported, analyzed, and compared.Results Male sex predominance was reported. Twentyseven infants were younger than 1 year old and the remaining patients were in their second year of life, with a mean age of 9.7 ± 4.9 months. The mean values of healing time were 21 ± 3.01 days for group A (range 17-28 days) and 26.6 ± 1.42 days for group B (range 25-30 days). There was a statistically significant difference between the two groups in both the operative time and the healing time. There was one recurrence and one granuloma in group B. One wound infection was reported in patients who underwent fistulotomy (group A). ConclusionThe treatment of FIA in infants remains controversial and it can be treated either by fistulotomy or by fistulectomy. However, there are fewer risks and shorter recovery times associated with fistulotomy as compared with fistulectomy. A future study involving nonoperative management would be required to assess other treatment options.

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Section: Discussionmentioning

confidence: 99%

Fistulotomy versus fistulectomy as a treatment for low anal fistula in infants

Gafar¹

2013

Annals of Pediatric Surgery

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“…In rezenten Studien hat sich eine primäre antibiotische Therapie als wirksam erwiesen und kann somit auch als erster Therapieversuch empfohlen werden (5,6). Jedoch sind hier häufig Rezidive beschrieben, sodass in bis zu 50 % der Fälle eine chirurgische Sanierung im Sinne der Fistulotomie bzw Fistulektomie erfolgte.…”

Section: W Krois Et Al: Die Häufigsten Proktologischen Erkrankungenunclassified

Die häufigsten proktologischen Erkrankungen bei Kindern

Arneitz¹,

Reck-Burneo²,

Krois³

2018

Kinder- und Jugendmedizin

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ZusammenfasssungIn diesem Artikel möchten wir auf typische proktologische Erkrankungen bei Kindern eingehen. Wir bieten praktische Empfehlungen mit Abgleich der aktuellen Literatur zu Themen wie rektale Polypen, Analfissuren, perianale Abszesse, Hämorrhoiden, Rektumund Analprolaps, ulzerative Dermatitis bei Kurzdarmsyndrom, Marisken und Hämangiome. Anorektale Fehlbildungen, Morbus Hirschsprung und entzündliche Darmerkrankungen werden bewusst ausgelassen, da diese an einer anderen Stelle ausführlich diskutiert werden. Die meisten der hier vorgestellten Erkrankungen können leicht von Kinder-ärzten mit konservativen Maßnahmen behandelt werden. In schweren oder hartnäckigen Fällen wird eine Vorstellung bei Kinder-chirurgen mit kolorektalem Schwerpunkt empfohlen.

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“…They are often encountered in infants younger than 12 months and display an extreme male predominance. 1,2) This sex-based difference may be explained by androgen excess or androgen-sensitive glands. 1) The abscess typically presents as a fluctuant tender mass in the perianal region, most commonly in the 3 o'clock and 9 o'clock positions.…”

mentioning

confidence: 99%

“…Lack of consensus in the treatment of these diseases makes choosing treatment difficult. Chang et al 2) advocated that conservative treatment for perianal abscess and fistula-in-ano could be the first choice of treatment. Christison-Lagay et al 7) reported the risk of fistula formation with nonoperative treatment of perianal abscess in infants.…”

mentioning

confidence: 99%

“…8) However, other articles defined incision and drainage with local care of the perianal abscess as conservative treatment. 2) There are different opinions regarding use of antibiotics in the treatment of perianal abscess and fistula-in-ano in literature. Afşarlar et al 1) concluded that simple drainage of the perianal abscess with additional antibiotic therapy reduces the development of fistula-in-ano.…”

mentioning

confidence: 99%

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