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Pediatr Surg Int (2011) 27:10631068 DOI 10.1007/s00383-011-2956-7
ORIGINAL ARTICLE
Perianal abscess and stula-in-ano in children: clinical characteristic, management and outcome
atay Evrim Afsarlar Ayse Karaman Gnl Tanr Ibrahim Karaman
Engin Ylmaz Derya Erdogan Hasim Ata Maden Yusuf Hakan avusoglu
Ismet Farukzgner
ag
Published online: 23 July 2011 Springer-Verlag 2011
AbstractPurpose The aims of this study are to evaluate the clinical characteristics of perianal abscess and stula-in-ano in children, and to assess our experience in treatment, and to identify factors that affected the clinical outcomes. Methods A retrospective review of children with perianal abscess and stula-in-ano was carried out in a tertiary care childrens hospital from January 2005 to December 2010. Demographic information of the patients, localization of the lesions, treatment procedures, microbial organisms in pus, usage of antibiotics, abscess recurrence, development of stula-in-ano, and duration of symptoms were recorded. Patients with systemic diseases and inammatory bowel diseases were excluded from the study.
Results A total of 158 children (146 males, 12 females) treated for perianal abscess and stula-in-ano with a median age of 7.2 months (ranging 16 days to 18 years) were eligible for the study. Initial examination of the 136 patients revealed perianal abscess and 22 patients with stula-inano. Primary treatment was incision and drainage (I/D) for the uctuating perianal abscess (73.5%), and local care for the spontaneously (S/D) drained abscess (26.5%) with or without antibiotic therapy. Patients were divided into two groups according to age distribution, 98 of the patients were younger than 12 months, and 60 were older than 12 months
of age. There was no signicant difference in sex distribution, localization of the lesions, treatment procedures, recurrence of abscess and stula-in-ano formation between the two age groups (p [ 0.05). Recurrence rates (27% in
I/D and 30.6% in S/D, p [ 0.05) and development of stula-in-ano (20% in I/D and 27.8 in S/D, p [ 0.05) were not signicant I/D and S/D groups. Kind of the microorganisms in pus swaps did not effect the stula-in-ano formation. Usage of antibiotics signicantly reduced the development of stula-in-ano (p = 0.001), but did not effect the recurrence of perianal abscess (p [ 0.05). The mean follow-up period was 10.6 8.6 months. While the 9 of the overall 52 stula-in-ano (22 initial, 30 after...