Fistula-in-ano in infancy and childhood

Perianal Abscess and Fistula-In-Ano in Infants: A Different Entity?

“…6,23 We used surgery in 28 patients after a mean observation of 3.2 months. As many others, 4,9,10,12,18 we performed a fistulectomy with laying open the wound, and used cryptotomy in 39.2 percent of the cases when an involved crypt was found. 2,8,13 As reported elsewhere, 2,8,20,23 we did not observed any recurrence after fistulectomy, although a recurrence rate of 5 to 25 percent was reported in some series.…”

“…1 Some cases were treated by needle aspiration of the abscess. 17 The most accepted approach is incision and drainage of the abscess 4,6,8,14,[17][18][19]21 under local anesthesia. 1,8,22 A more radical approach, using incision with simultaneous fistulotomy and cryptotomy under general anesthesia, has been found to reduce significantly the recurrence or FIA rate.…”

“…Our results of 36.4 percent of evolution toward an FIA after needle aspiration is comparable with the published data, which varies from 33 to 42 percent 2,6,8,13,21 to 65 to 77 percent. 1,4 In all cases defined as an FIA, there was a persistent perianal hole with purulent discharge. The existence of an internal opening of the fistula was demonstrated only in patients who underwent fistulectomy.…”

“…[1][2][3][4] The gender ratio in adults is (M:F) 2:1, whereas in infants it is almost an exclusively male disease. Systemic signs of sepsis, and sometimes of overwhelming sepsis, are frequently present with PA in adults but are uncommon in infants.…”

The evaluation of bacteriology in perianal abscesses of 81 adult patients

“…10 In this study, male/female ratio was 5.7 and it was similar in studies by Lunniss and Philips 11 and Toyonaga et al In pediatric population, the male predominance is even more pronounced. 13 On the other hand, the vast majority of PAes, however, are treated in the outpatient setting, and the true incidence is hard to defi ne. The mean age of patients was 39.8 and it was similar to other studies.…”