Surgical treatment of perianal abscess and fistula-in-ano in childhood, with emphasis in children older than 2 years

The pathogens and curative effects analysis of perianal abscess of infants under 3 months

“…They are usually superficial entities close to the anus; however the variability in size, precise location, and relation to the anal sphincter system, in addition to the deficiency of information on underlying fistulae and the lack of contemporaneous ultrasound or magnetic resonance imaging studies, have contributed to the confusion and variability regarding treatments. 1,2 Thereby, until now, perianal abscess remains unclassified, without unanimous data regarding treatment and surgical techniques that should be adopted. Recurrence or development of fistula-in-ano rates after initial treatment of perianal abscess are reported in 0 to 85% of cases.…”

Treatment of First-Time Perianal Abscess in Childhood, Balance Recurrence and Fistula Formation Rate with Medical Intervention

“…We did not find that previous studies had reported more frequent recurrence of perianal abscesses in younger 2,8,9 or in older children. 3 Perianal abscess in the infant population is idiopathic. In concordance with previously published series, our series consisted predominantly of male infants who were younger than 4 months of age.…”

“…Perianal abscess is an anorectal disorder affecting both children and adults, 1 who may experience considerable discomfort. 2,3 A strong male predominance is evident, with peak onset at ages < 1 year. 4,5 One theory is that such abscesses in children arise from abnormal crypts of Morgagni.…”

“…This wide range may be due to therapeutic differences (i.e., conservative management vs. surgical intervention) or conventions in reporting and designating fistulas as recurrences or complications. [1][2][3][4][6][7][8][9] Although conservative management is the most frequently used and first-opted approach, surgical intervention, which includes incision and drainage (ID), drainage change alone, or fistulotomy of first-time perianal abscess, may be needed if the conservative treatment cannot control the condition. In fact, the indication for surgical intervention remains obscure and controversial.…”

“…In fact, the indication for surgical intervention remains obscure and controversial. [1][2][3][4][6][7][8][9][10][11] The objective of this retrospective study was to investigate the clinical course and RF rates of first-time perianal abscesses in children < 15 years old, comparing outcomes in the aftermath of conservative management with those after surgical treatment.…”