Management of perianal abscess and fistula-in-ano in infants and children

Incidence and diagnostic performance of ultrasound for perianal abscess or fistula‐in‐ano in pediatric patients with perianal inflammation

“…Ultrasound can help detect fistula‐in‐ano and perianal abscess to inform surgical interventions such as drainage or incision; accordingly, it is useful as a supplement to physical examination for the diagnosis and management of patients with perianal inflammation 1,25 …”

“…Therefore, it is important to consider factors related to abscess formation. Perianal abscess and fistula‐in‐ano can occur in infants without underlying disease; 1,25 therefore, related symptoms in infants who cannot express complaints may be difficult to detect and the lesions may progress. Contrastingly, older patients can express related symptoms more easily than infants.…”

“…Perianal inflammation, including perianal abscess and fistula‐in‐ano, is a common complication in children resulting from cryptitis‐caused bacterial entrapment at a thickened dentate line; further, it can progress to perianal abscess with or without healing and develop into a fistula‐in‐ano 1–6 . Physical examination as well as imaging examinations such as ultrasound, magnetic resonance imaging (MRI), and computed tomography (CT) can be used to detect and diagnose perianal abscess and fistula‐in‐ano 2–6 .…”

Metabolic impact of adipose tissue macrophages in the early postnatal life

“…However, analysis of ATMs is still not a routine diagnostic approach, despite the access to adipose tissue specimens is relatively simple during a wide range of elective surgeries in pediatric patients. For instance, approximately 2–8% of male infants are affected by cryptorchidism, 133 1–6% of infants and children may develop inguinal hernia, 134 and infections in the first year of life often lead to the development of anal abscesses and fistulas 135 . When these conditions require surgical repair, there is an inevitable removal of small volumes of adipose tissue from the inguinal canal, the subcutaneous fat layer of the groin region, or the fat pad of the ischiorectal fossa, respectively.…”

“…For instance, approximately 2–8% of male infants are affected by cryptorchidism, 133 1–6% of infants and children may develop inguinal hernia, 134 and infections in the first year of life often lead to the development of anal abscesses and fistulas. 135 When these conditions require surgical repair, there is an inevitable removal of small volumes of adipose tissue from the inguinal canal, the subcutaneous fat layer of the groin region, or the fat pad of the ischiorectal fossa, respectively. Since these fat depots are present at birth and remain persistent throughout life, they offer the possibility of studying ATM ontogeny and describing changes in ATM number or phenotype in course of postnatal development.…”