• Advances in pediatric surgery
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• v.16 no.2
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• pp.170-176
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• 2010

The clinical characteristics of fistula-in-ano in infants are different from those of older children, and its treatment remains controversial. We suggest that fistula-in-ano in infants has a congenital etiology. To verify this hypothesis and to settle the controversies regarding fistula-in ano in infants, a retrospective analysis of 29 patients less than 2 years of age with anal fistulae treated between 1994 and 2009 at Samsung Changwon Hospital were reviewed retrospectively. Twenty two patients were male and mean age at diagnosis was $7.2{\pm}5.2$ months. Eleven out of 22 cases had previous surgical drainage for perianal abscess. 18 patients had fistulotomy (81.8 %) and four had fistulectomy (18.2 %). Cryptotomies with fistulectomy were performed in 10 patients (45.5 %) who had involved crypt. There was one recurrence. These results suggest that fistula-in-ano in young children less than two years of age is different from those in older children or adults. Fistulotomy is suggested to be the recommended treatment of choice. A future study involving non-operative management would be required to explore all treatment options.

• Advances in pediatric surgery
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• v.8 no.2
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• pp.133-137
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• 2002

To evaluate the clinical characteristics and results of treatment of fistula-in-ano and perianal abscess in childhood, we analyzed 95 cases of fistula-in-ano and/or perianal abscess seen in childhood, between January 1995 and June 2001 at the Department of General Surgery of Ewha Womans University Mokdong Hospital. Perianal abscess was in 25 patients, anal fistula in 62 and combined disease (perianal fistula and abscess) in 8. Male predominance was noted (95%). Median age was 8 months and 78% of cases were presented under the age of 1 year. Median duration of symptoms was 60 days. Twenty four abscesses (77%) and 18 lesions (72%) of combined disease (n=25) were located on both lateral sides of the anus, and fistulas located on both lateral sides were 33 (53%). Multiplicity of the lesion was noted in 25% of cases. Sixteen percent of abscess, 81% of fistula and 88% of combination group have had previous perianal abscesses. The perianal abscesses were treated with incision and currettage and fistulas were treated with fistulotomy or fistulectomy. There were no recurrent diseases and no complications after surgical treatment. Although the progresses of the perianal abscess and fistula in ano in childhood may be self-limitied, surgical management was safe and curable.

• Clinical and Experimental Pediatrics
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• v.63 no.7
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• pp.261-262
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• 2020

• Advances in pediatric surgery
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• v.8 no.1
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• pp.6-10
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• 2002

To clarify the necessity of surgery for fistula-in-ano (FIA) in infant, a retrospective analysis of 82 cases FIA in infant were performed for 11 years period from 1987 to 1998. Group A included 44 cases in the period of surgery oriented treatment to 1992, and group B contained 38, period of feeding control oriented management (FC) after 1993. FC, that was indicated in case with loose stool and eczematoid perianal skin (LSES), composed of quit breast feeding, change of cow milk or complete weaning. Surgical decision was made after improvement of stool condition. Fistulectomy was performed in 29 cases (65.9 %) of group A. However, in group B, only 15 cases (39.5 %) required surgery (p=0.0036). Thirty-four cases in B had the history of LSES, and Fe was applied in 25, and was effective in 24. Among 24 cases, 21 showed complete healing with FC, 3 had surgery because of the persistent FIA, and 1 got operation due to no improvement of stool condition. In conclusion, Fe has to be applied to FIA in infant before surgery, particularly in cases with history of LSES. As one of the etiologic factors for FIA, LSES could be considered to this particular age group.