“…This theory was supported by intraoperative findings. 2,3,13,14 In more than one-third of our patients operated on for FIA, a connection to an abnormal crypt was found. An underlying congenital anatomic abnormality as an etiology of PA/FIA in infants is also supported by the appearance of the disease in infants.…”
Local treatment for perianal abscess during the early stage and drainage by needle aspiration during the progressive stage are effective. Antibiotics may be considered for patients undergoing drainage of perianal abscess. Fistula-in-ano can be managed conservatively for one to three months. For a persisting fistula, fistulectomy with cryptotomy (when abnormal anal crypts are found) is the preferred treatment.
“…This theory was supported by intraoperative findings. 2,3,13,14 In more than one-third of our patients operated on for FIA, a connection to an abnormal crypt was found. An underlying congenital anatomic abnormality as an etiology of PA/FIA in infants is also supported by the appearance of the disease in infants.…”
Local treatment for perianal abscess during the early stage and drainage by needle aspiration during the progressive stage are effective. Antibiotics may be considered for patients undergoing drainage of perianal abscess. Fistula-in-ano can be managed conservatively for one to three months. For a persisting fistula, fistulectomy with cryptotomy (when abnormal anal crypts are found) is the preferred treatment.
“…Children typically present with fistula before 1 year of age and are overwhelmingly male [1]. Studies have previously shown that it is likely of congenital etiology [2] and is often preceded by an abscess [3].…”
Fistula in ano in infants is a relatively benign process with most children having no serious sequelae. However, a not insignificant portion (13%) of children developed recurrences. Older children who developed fistulas were more likely to have a recurrence than younger, and children who had previous episodes of perianal abscess or pus noted at the time of surgery were more likely to recur.
“…Andere Arbeitsgruppen tendieren hingegen zu einem "minimal invasiven Eingriff ", wobei mit einer Nadel der Abszessinhalt aspiriert wird [20]. Die meisten Arbeiten favorisiert aber weiterhin die Abszessinzision und -drainage in Allgemeinanästhesie [2,6,10,13,18,19].…”
Section: Therapieunclassified
“…Leider finden sich bisher für die eine oder anderer Therapieform nur kleine Fallzahlen [2,6,10,13,18,19,20,23,24], eine randomi- Kinder wurden innerhalb des 1. Lebensjahres und weitere 10% innerhalb des 2.…”
Section: Therapieunclassified
“…Beim Vorliegen einer Fistel hat die kausale Therapie unserer Meinung nach auch weiterhin in einer vollständigen Entfernung des Fistelganges zu bestehen, da eine inkomplett resezierte Fistel mit einer hohen Wahrscheinlichkeit als Quelle weiterer Fistelrezidive anzusehen ist [6]. Obwohl es sich bei den Fisteln im Säuglings-und Kleinkindesalter in ihrer Mehrzahl um subkutane Fisteln handelt, sollte eine Therapie jedoch nur in speziellen Kliniken durchgeführt werden, um eine Läsi-on des Sphinkterapparates zu vermeiden.…”
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