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Perianal abscess and fistula-in-ano in infants
1Pediatric Surgical Center, University Hospital Nijmegen, The Netherlands.
Insights
Infants with perianal abscesses often develop fistulas. Surgical treatment for pediatric fistula-in-ano has a short-term recurrence risk, but long-term outcomes are generally favorable with no serious disabilities.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Proctology
Background:
- Perianal abscesses and fistulas-in-ano are relatively common in infants.
- Understanding treatment outcomes is crucial for pediatric surgical practice.
Purpose of the Study:
- To evaluate the short- and long-term results of treating perianal abscess and fistula-in-ano in infants.
- To provide insights into recurrence rates and functional outcomes following surgical intervention.
Main Methods:
- Retrospective analysis of patient records from a Pediatric Surgical Center over a 21-year period (1974-1994).
- Inclusion of a long-term follow-up (1-24 years, mean 7.74 years) via questionnaire with an 81% response rate.
Main Results:
- Fistula development occurred in 35% of cases following perianal abscess drainage.
- Recurrence rates after fistulotomy or fistulectomy were 13%, with two late spontaneous resolutions.
- Most children aged 3+ achieved fecal continence; minor issues like soiling, constipation, or nocturnal incontinence were infrequent.
Conclusions:
- Simple drainage of perianal abscesses in infants frequently leads to fistula formation.
- Fistula-in-ano treatment in infants carries a moderate short-term recurrence risk but exceptional long-term recurrence.
- Surgical interventions for pediatric perianal abscesses and fistulas generally result in favorable long-term functional outcomes without significant disabilities.
Purpose:
The aim of this study was to obtain insight into the short- and long-term results of treatment of perianal abscess and fistula-in-ano in infants.
Methods:
This is a retrospective study of the records of patients treated over a 21-year period from January 1974 until December 1994 in a Pediatric Surgical Center. A long-term (1 to 24 year, mean 7.74 year) follow-up by questionnaire (response 81%) is also included.
Results:
Drainage of a perianal abscess is followed in 35% of cases by a fistula. Fistulotomy or fistulectomy is followed in 13% of cases by a recurrence. There were two long-term recurrences that both healed spontaneously. The persisting scar sometimes gives problems with anal cleaning. All children aged 3 years and older were continent for feces. In two, there was soiling for some time. One had constipation and one was incontinent during the night.
Conclusions:
Simple drainage of a perianal abscess is followed frequently by a fistula. Fistulotomy or fistulectomy of a fistula-in-ano in infants has a reasonable chance of recurrence in the short term. Long-term recurrences are exceptional. There are no serious disabilities in the long run.