Perianal abscess in childhood

Perianal abscess (PA) is a common condition encountered in childhood, but its optimal primary treatment is uncertain. Treatment of PA by incision and drainage (I & D) alone is associated with an unacceptably high recurrence rate, either as fistula-in-ano (FIA) or as PA. To identify possible caus...

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Bibliographic Details
Published in:Pediatric surgery international 2002-12, Vol.18 (8), p.689-691
Main Authors: MURTHI, G. V. S, OKOYE, B. O, SPICER, R. D, CUSICK, E. L, NOBLETT, H. R
Format: Article
Language:English
Subjects:
Abscess - surgery
Adolescent
Anus Diseases - surgery
Biological and medical sciences
Child
Child, Preschool
Drainage
Female
Fissure in Ano - surgery
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Infant
Infant, Newborn
Male
Medical sciences
Other diseases. Semiology
Recurrence
Retrospective Studies
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
Treatment Outcome
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Summary:Perianal abscess (PA) is a common condition encountered in childhood, but its optimal primary treatment is uncertain. Treatment of PA by incision and drainage (I & D) alone is associated with an unacceptably high recurrence rate, either as fistula-in-ano (FIA) or as PA. To identify possible causes of recurrence and assess the value of concomitant laying open of a fistulous tract at the time of primary incision and drainage, the case notes of all children who presented to our institution with a PA between January 1992 and January 1997 were reviewed retrospectively. Thirty-three cases were identified (29 boys and 4 girls). A fistulous tract was identified and laid open at the time of primary drainage in 20 cases, whilst 13 were treated by I & D alone. Following primary drainage, there were 7 recurrences (21.2%) (FIA 5 and PA 2). All recurrences had been primarily treated by drainage alone, whilst there were no recurrences in patients who had also undergone fistulotomy at the time of primary drainage. Thus the primary treatment of PA in childhood should involve a careful search for a coexisting fistula and treatment of this by fistulotomy.
ISSN:0179-0358
1437-9813
DOI:10.1007/s00383-002-0761-z