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Clinical characteristics and treatment of perianal abscess and fistula-in-ano in infants

 Hye Kyung Chang  ;  Je Gyu Ryu  ;  Jung-Tak Oh 
 JOURNAL OF PEDIATRIC SURGERY, Vol.45(9) : 1832-1836, 2010 
Journal Title
Issue Date
Abscess/diagnosis ; Abscess/therapy* ; Anus Diseases/diagnosis ; Anus Diseases/therapy* ; Humans ; Infant ; Male ; Rectal Fistula/diagnosis ; Rectal Fistula/therapy* ; Retrospective Studies ; Risk Factors
Perianal abscess ; Fistula-in-ano ; Infant ; Conservative treatment ; Fistulectomy
PURPOSE: 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. METHOD: 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. CONCLUSION: Conservative treatment of perianal abscess and fistula-in-ano has an excellent outcome and could be the first choice of treatment of these diseases.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Oh, Jung Tak(오정탁)
Chang, Hye Kyung(장혜경)
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