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[Perianal abcess in infant].

L Barthés-Anidjar1, M Wolter, C Bodemer

  • 1Service de Dermatologie, Hôpital Necker-Enfants-Malades, 149, rue de Sèvres, 75015 Paris.

Annales De Dermatologie Et De Venereologie
|May 15, 2003
PubMed
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Perianal abscesses in infants under one year are often linked to congenital abnormalities, not predisposing conditions. Surgical drainage is common, but non-operative management is emerging for healthy infants.

Area of Science:

  • Pediatric Surgery
  • Neonatal Care
  • Gastroenterology

Background:

  • Perianal abscess and fistula-in-ano are uncommon in infants under 1 year.
  • Congenital abnormalities of the crypts of Morgagni are suspected as the origin.
  • Predisposing conditions are rare in this age group.

Observation:

  • A 7-week-old infant presented with a perianal abscess.
  • Biological tests revealed no neutropenia or inflammatory syndrome.
  • Surgical drainage was performed, and no fistula was identified during the procedure.

Findings:

  • Perianal abscesses in infants may arise from anal cryptitis secondary to congenital abnormalities.
  • Fetal androgen excess could contribute to abnormal crypt formation.
  • A significant percentage of infant perianal abscesses may progress to fistula formation.

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Implications:

  • Standard treatment involves incision and drainage, potentially followed by fistula surgery.
  • Antibiotic therapy is not always necessary.
  • Non-operative management is a potential alternative for healthy infants with perianal abscess/fistula.