Clinical characteristics and treatment of perianal abscess and fistula-in-ano in infants.
OBJECTIVE
The aims of this study were to evaluate the clinical characteristics of perianal abscess and fistula-in-ano in infants and to identify factors that affected the clinical outcomes.


METHODS
The authors retrospectively reviewed the clinical data of 112 infants who were treated for perianal abscess and fistula-in-ano by a single pediatric surgeon from January 2006 to December 2008.


RESULTS
All patients were male and the mean age of infants presented to our hospital was 6.0 ± 4.5 months. One hundred one patients (90.2%) had 1 or 2 perianal lesions, and 76 (67.9%) had lesions at the 3 and/or 9-o'clock directions. The use of oral antibiotics did not improve or aggravate the lesions in 29 of 37 cases. Ninety-seven patients (86.6%) were cured by conservative treatment with a mean duration of 5.2 ± 3.9 months from the onset of the disease to the cure. The mean age of curing was 9.0 ± 4.9 months. Feeding formula change showed improvement of stooling in 38 (62.3%) of 61 patients but did not affect the duration of conservative treatment. Multiple linear analysis revealed that the presence of multiple lesions was a significant independent variable (P = .001) for the duration of conservative treatment, but age of the onset and location of the lesion were not. Twelve patients (10.7%) underwent fistulectomy at a mean age of 15.0 ± 5.1 months. None of the patients had recurrences after operation for the mean follow-up period of 23.7 ± 11.7 months.


CONCLUSIONS
Conservative treatment of perianal abscess and fistula-in-ano has an excellent outcome and could be the first choice of treatment of these diseases.
Chang
Hye Kyung
HK
Department of Pediatric Surgery, Severance Children's Hospital, Yonsei University College of Medicine, Seoul 120-752, South Korea.
Ryu
Je Gyu
JG
Oh
Jung-Tak
JT
D000038:Abscess / Q000175:diagnosis / Q000628:therapy*; D001004:Anus Diseases / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D007223:Infant; D008297:Male; D012003:Rectal Fistula / Q000175:diagnosis / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors