Treatment of perianal abscess in children: spontaneous drainage or incision-drainage?
Erten, E., Öztorun, C., Ertürk, A., Güney, D., Bostancı, S., Öcal, M., Demir, S., Azılı, M., Şenel, E. (2022). Treatment of perianal abscess in children: spontaneous drainage or incision-drainage?. EKB Journal Management System, 18(1), -. doi: 10.1186/s43159-022-00201-3
Elif Emel Erten; Can İhsan Öztorun; Ahmet Ertürk; Doğuş Güney; Süleyman Arif Bostancı; Medine Ezgi Öcal; Sabri Demir; Müjdem Nur Azılı; Emrah Şenel. "Treatment of perianal abscess in children: spontaneous drainage or incision-drainage?". EKB Journal Management System, 18, 1, 2022, -. doi: 10.1186/s43159-022-00201-3
Erten, E., Öztorun, C., Ertürk, A., Güney, D., Bostancı, S., Öcal, M., Demir, S., Azılı, M., Şenel, E. (2022). 'Treatment of perianal abscess in children: spontaneous drainage or incision-drainage?', EKB Journal Management System, 18(1), pp. -. doi: 10.1186/s43159-022-00201-3
Erten, E., Öztorun, C., Ertürk, A., Güney, D., Bostancı, S., Öcal, M., Demir, S., Azılı, M., Şenel, E. Treatment of perianal abscess in children: spontaneous drainage or incision-drainage?. EKB Journal Management System, 2022; 18(1): -. doi: 10.1186/s43159-022-00201-3

Treatment of perianal abscess in children: spontaneous drainage or incision-drainage?

Annals of Pediatric Surgery
Volume 18, Issue 1, January 2022  XML PDF (996.23 K)
DOI: 10.1186/s43159-022-00201-3
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Authors
Elif Emel Erten email ; Can İhsan Öztorun; Ahmet Ertürk; Doğuş Güney; Süleyman Arif Bostancı; Medine Ezgi Öcal; Sabri Demir; Müjdem Nur Azılı; Emrah Şenel
Abstract
Background
The aim of the study is to evaluate the clinical characteristics and compare the treatment methods for perianal abscesses by assessing our treatment experiences.
Methods
We have retrospectively analyzed the records of the children who received perianal abscess and fistula-in-ano treatment between January 2014 and January 2022. Demographic information of the patients, complaints, treatment procedures, abscess recurrence, and development of fistula-in-ano was evaluated. Patients with systemic diseases and inflammatory bowel diseases were excluded from the study.
Results
A total of 312 children (230 boys, 82 girls) were included in the study. The median age was 24.3 ± 18.1 months (1–216). In the first examination, 61 (19.5%) patients had fistula-in-ano and 25 1(80.5%) patients had a perianal abscess. The most common symptoms were erythema in the perianal region, mass, constipation, rectal bleeding, and inability to defecate. Spontaneous drainage was determined in 34.3% ( = 86) of the perianal abscess, and 65.7% ( = 165) of perianal abscesses were treated with incision-drainage without general anesthesia and systemic antibiotherapy. In the follow-up, fistula-in-ano formed in 27 patients who had a perianal abscess. Twenty-four of the patients who developed fistula-in-ano, were seen after spontaneous drainage, and 3 of them were seen after incision drainage. Perianal abscess recurred in 64 patients. Spontaneously drained abscess significantly increased the development of fistula-in-ano ( = 0.001). However, recurrences in a perianal abscess (25.4%) do not increase the fistula-in-ano formation ( > 0.05). In fistula-in-ano treatment, 10 (11.5%) patients were resolved spontaneously, 70 (79.5%) patients were treated with fistulotomy and 8 (9%) patients were treated with fistulectomy.
Conclusion
Treatment of perianal abscess and fistula-in-ano in children is still controversial. According to our results, incision-drainage and antibiotic usage in the treatment of the perianal abscess are the most appropriate treatment to decrease the rate of fistula-in-ano.
Keywords
Child; Perianal abscess; Fistula-in-ano; Recurrence; Incision-drainage; Spontaneous drainage
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