Perianal Abscess and Fistula-in-Ano in Infants

Choe, Jun Ho; Kim, Hyun Young; Jung, Sung Eun; Lee, Seong Cheol; Park, Kwi Won; Kim, Woo Ki

Abstract

PURPOSE
A number of studies have reported obtaining satisfactory results from the nonoperative management of perianal abscess (PAA) and/or fistula-in-ano (FIA) in infancy. The aim of this study was to obtain insight into the results of different treatment for perianal abscess and/or fistula- in-ano in infants. METHODS: This is a retrospective study utilizing the medical records of patients treated from March 1997 until January 2004 at our Pediatric Surgical Center. Follow-up on patients by telephone was done when necessary and these findings were also included in the results. RESULTS: One hundred twenty four patients were analyzed (122 boys and 2 girls). 113 patients of the 124 patients (91.9%) were under the age of 1 year. 93 lesions of the total 131 lesions (70.0%) were laterally located. 73 (88.0%) of the 83 identified patients(confirmed cases whether cured or not) were cured within 12 months, and 78 (94.0%) of the 83 patients were cured without surgical intervention within 24 months. The numbers of PAA and FIA were 68 and 15 respectively. PAA was cured within 1 month for 27 children (39.7%), and within 6 months for 51 children (75%). FIA was cured within 6 months for 8 children (53.3%) but there were no cases of FIA cured within 1 month. CONCLUSIONS: In healthy infants, PAA and FIA are self- limited conditions that rarely require a surgical drainage procedure such as fistulotomy or fistulectomy, and these conditions do not require antibiotics. So we prefer conservative management techniques such as sitz bath and/or simple drainage to radical surgery.