Evaluation of the Causes of Perianal Abscess in Childhood

Aygün, Deniz; Akçakaya, Necla; Çokuğraş, Haluk; Camcioğlu, Yıldız

doi:10.5578/ced.201904

Cited by 3 publications

(5 citation statements)

References 21 publications

(32 reference statements)

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“…6 Additionally, several predisposing disorders may also be responsible for the development of an abscess, such as inflammatory bowel disease (IBD), anorectal malformations, and immunodeficiency. 7,8 With a clear predominance of males, most children have the onset of PA in the first year of life. 9,10 Various therapies have been applied, while decision-making on choosing the treatment depends on the experiences and judgments provided by physicians, as well as the tendency of caregivers.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…It is widely accepted that abscesses arise from the obstruction of anal glands 6 . Additionally, several predisposing disorders may also be responsible for the development of an abscess, such as inflammatory bowel disease (IBD), anorectal malformations, and immunodeficiency 7,8 . With a clear predominance of males, most children have the onset of PA in the first year of life 9,10 .…”

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confidence: 99%

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A Systematic Review and Meta-Analysis of Comparing Drainage Alone versus Drainage with Primary Fistula Treatment for the Perianal Abscess in Children

et al. 2023

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Background This systematic review and meta-analysis of non-randomized studies (NRSs) aimed to evaluate the clinical efficacy and safety of two types of surgical interventions (respectively drainage alone and drainage with primary fistula treatment) for perianal abscesses (PAs) in children. Materials and Methods Studies from 1992 to July 2022 were searched in 10 electronic databases. All relevant NRSs with available data which compared surgical drainage with or without primary fistula treatment were included. Patients with underlying diseases which led to abscess formation were excluded. The Newcastle-Ottawa Scale (NOS) was used to assess the risk of bias and quality of the included studies. The outcomes were the healing rate, fistula formation rate, fecal incontinence, and wound healing duration. Results A total of 16 articles with 1,262 patients were considered suitable for the final meta-analysis. Primary fistula treatment was associated with a significantly higher healing rate when compared with incision and drainage alone (OR 5.76, 95% CI 4.04-8.22). This aggressive procedure for PA resulted in an 86% reduction in the fistula formation rate (OR 0.14, 95% CI 0.06-0.32). Limited data showed patients who underwent primary fistula treatment have a minor effect on postoperative fecal incontinence. Conclusion Primary fistula treatment demonstrates a better clinical efficacy in promoting the healing rate and decreasing the formation of fistulas in PAs in children. The available evidence for a minor impact on anal function after this intervention is less strong.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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A Systematic Review and Meta-Analysis of Comparing Drainage Alone versus Drainage with Primary Fistula Treatment for the Perianal Abscess in Children

et al. 2023

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“…The predisposition to crypto glands infection might be associated with hyperfunction of anal glands induced by an excess of androgen [6,8]. Additionally, certain underlying conditions such as anorectal malformation, inflammatory bowel disease, and immunodeficiency disorders have also been suggested as potential causes of FIA [9][10][11]. In infants and toddlers, FIA can sometimes be caused by injuries to the rectum and anus due to improper care [12,13].…”

Section: Introductionmentioning

confidence: 99%

A case-control study of the risk factors for fistula-in-ano in infants and toddlers

Sun,

Liang,

Hao

et al. 2024

BMC Pediatr

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Background Limited data are available regarding the risk factors for fistula-in-ano (FIA) in infants and toddlers, potentially affecting their daily lives. Objectives The purpose of this study was to identify potential risk factors for FIA in infants and toddlers, in order to implement early preventive interventions, avoid disease progression, and develop therapeutic strategies. Design and settings A retrospective case-control study was conducted, comparing 41 infants and toddlers diagnosed with FIA with 41 healthy controls, between August 2020 and December 2021. Independent variables (a) maternal characteristics during pregnancy and delivery, (b) perinatal characteristics, dietary behaviors, and defecation-related behaviors in infants and toddlers, (c) family dietary behaviors. Results Mothers of infants and toddlers with FIA had given birth more times in the past, while the infants and toddlers themselves had less mealtime, a higher rate of exclusive breastfeeding, frequent loose stools, and a larger proportion of used wipes, experiencing perianal skin anomalies. The logistic regression analysis revealed that there are four significant risk factors associated with the development of FIA in infants and toddlers, including the number of previous deliveries by the mother (OR 6.327), defecation frequency score (OR 5.351), stool consistency score (OR 5.017), and cleaning with wipes after defecation (OR 8.089). Conclusion Based on our data, it appeared that FIA in infants and toddlers could be attributed to several factors. These included an increased number of previous deliveries by mothers, frequent loose stools, and repeated wipe use. To prevent the occurrence and worsening of the disease, it is important to improve the frequency and consistency of stooling and provide proper care. Further research is required to verify these findings in other clinical settings.

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“…ARAs are often reported to be polymicrobial in nature, involving complex interactions between multiple microbial species. This polymicrobial aspect complicates the diagnosis and treatment, as different bacteria may have varying susceptibility to antibiotics [13][14][15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Aerobic Microbiological Spectrum and Antibiotic Resistance in Children Operated for Anorectal Abscesses

Chakarov,

Hadzhieva,

Kalchev

et al. 2024

JCM

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(1) Background: Anorectal abscesses are a relatively rare pathology in childhood. Most often, male children under 1 year of age are affected. The importance of microbiological examination for the diagnosis and treatment of such patients remains debatable among surgeons, resulting in scarce data being available in the literature. We aimed to identify the aerobic microbiological spectrum and antibiotic resistance of isolates in children undergoing operation to treat anorectal abscesses. (2) Methods: We performed a case series of 102 children diagnosed and operated for anorectal abscesses over a period of 10 years (2010–2019). Purulent wound exudate was used for microbiological evaluation, which was subsequently cultured on 5% sheep-blood agar and eosin–methylene blue agar. For microbiological identification, conventional biochemical tests and semi-automated (API 20, bioMerieux, Marcy-l’Étoile, France) tests were used, as well as automated systems (Vitek-2 Compact, bioMerieux, France). Antimicrobial susceptibility testing was performed by the disk diffusion method of Bauer–Kirby and by determining the minimal inhibitory concentrations for glycopeptides. The results were interpreted according to the EUCAST standard for the corresponding year. (3) Results: Microbiological testing in children operated for anorectal abscesses mainly identified the gut commensals that normally reside in the rectal mucosa. Monocultures were found in just over half of the cases. Escherichia coli, Klebsiella pneumoniae complex, and Proteus mirabilis were the most frequently isolated. In addition, Staphylococcus aureus was found in 7% of patients. In Gram-negative bacteria, antibiotic resistance was most often observed in penicillins, cephalosporins, sulfonamides, and fluoroquinolones. (4) Conclusions: The increasing rates of antimicrobial resistance impose the need for the local monitoring of circulating commensal bacteria associated with anorectal abscesses in children to guide antibiotic therapy when indicated.

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Evaluation of the Causes of Perianal Abscess in Childhood

Cited by 3 publications

References 21 publications

A Systematic Review and Meta-Analysis of Comparing Drainage Alone versus Drainage with Primary Fistula Treatment for the Perianal Abscess in Children

A Systematic Review and Meta-Analysis of Comparing Drainage Alone versus Drainage with Primary Fistula Treatment for the Perianal Abscess in Children

A case-control study of the risk factors for fistula-in-ano in infants and toddlers

Aerobic Microbiological Spectrum and Antibiotic Resistance in Children Operated for Anorectal Abscesses

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