Document Detail

Perianal abscess in children: aiming for optimal management.
MedLine Citation:
PMID:  22507498     Owner:  NLM     Status:  In-Data-Review    
Background:  Perianal abscess is common in infants and children, yet the optimal surgical management is argued: incision and drainage alone is a simple procedure but is associated with a much higher recurrence rate than incision and drainage with simultaneous laying open of the associated fistula. This retrospective review established the institutional recurrence rate and its close association with how the fistula was managed at the initial operation. Methods:  A retrospective review of all children requiring an operation for a perianal abscess over a 13-year period from 1996 to 2009 was performed. Data were compared with published series. Results:  A fistula was sought in 89 of 91 (98%) patients, and identified in 66 (73%). Recurrence occurred in 5/66 (8%) in whom a fistula was identified at the initial operation, compared with 6/25 (24%) (P = 0.06) in whom a fistula was not identified. Conclusion:  Recurrence of perianal infection is influenced by whether a fistula was identified and laid open at the initial operation. The recurrence rate is higher when the abscess is treated with incision and drainage alone. Given the ease with which most fistulae may be identified, and laid open without morbidity, optimal treatment involves drainage of the abscess and laying open of the fistulous tract.
Emily Buddicom; Amy Jamieson; Spencer Beasley; Sebastian King
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Publication Detail:
Type:  Journal Article     Date:  2012-01-09
Journal Detail:
Title:  ANZ journal of surgery     Volume:  82     ISSN:  1445-2197     ISO Abbreviation:  ANZ J Surg     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-04-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101086634     Medline TA:  ANZ J Surg     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  60-2     Citation Subset:  IM    
Copyright Information:
© 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.
Department of Paediatric Surgery, Christchurch Hospital, Christchurch, New Zealand.
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