• Advances in pediatric surgery
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• v.16 no.1
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• pp.32-36
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• 2010

Condyloma acuminatum is an uncommon disease but there is an increased incidence reported in recent years in prepubertal children. Anal and perianal condyloma accuminatum in children may suggest sexual abuse and treatment should include the thorough social evaluation as well as medical treatment. A 25 month old girl presented with multiple sessile nodules around her anal and perianal area, Biopsy confirmed the diagnosis of condyloma accuminatum. There was no definite evidence of sexual abuse, but her father had condyloma accuminatum involving his penis. The patient's lesions were excised totally. At three week follow up there was no anal stricture but there were newly developed small lesions around perianal area. Imiquimod onit was applied for 2 weeks and the recurred lesion disappeared completely. At postoperative 5 month, the operative area was fully epithelialized without recurrence.

• Advances in pediatric surgery
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• v.1 no.1
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• pp.40-45
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• 1995

Anal fistula and perianal abscess in pediatric patients have been reported to have several characteristics, e.g. prevalent in less than 2 years of age, male preponderance, straight course of tract, and low type of fistula. We performed a retrospective study of twenty nine pediatric patients to see these characteristics comparing with the transitional age group of adolescents. Between June 1989 and December 1993, twenty-nine pediatric (<15year-old) and sixteen adolescent patients(${\geqq}$15, <25 year-old) with anal fistula and perianal abscess were treated by surgical intervention. Perianal abscess and anal fistula in the pediatric group had the predilection for male(100%), age less than two years (72.4%), low type(100%), and lateral localization(87.5%). But the features of the adolescent group were similar to those of adult. Twenty-one(87.5%) and 10(66.7%) enteric bacterial colonies were isolated from 16 pediatric and 11 adolescent patients, respectively. Considering the predominance of low type and the organisms cultured in the pediatric group, crypt-glandular infection seems to be a major preceding event. Incision and drainage were sufficient for cure in 15 among 16 perianal abscesses, and fistulas were cured by either fistulotomy or fistulotomy in all the 14 patients. The importance of effective drainage of perianal abscess and fistulotomy including internal opening cannot be overemphasized.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.29 no.2
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• pp.180-186
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• 2016

Anal and perianal condyloma acuminatum(CA), which is a large cauliflower-like tumor, is a manifestation of human papillomavirus (HPV) infection. HPV may be acquired via sexual transmission, vertical transmission or nonsexual contact. It is an uncommon condition in children but the incidence in children has been increasing recently. There are many therapies for CA including chemical or physical destruction, immunological therapy, or a surgical excision. All these procedures have some degree of limitations such as limited clearance rate, high recurrence rate, pain, bleeding, release of potentially infectious aerosols and scar. It may be traumatic mentally to the children as well as physically. Korean Medicine included herbal treatment and herbal ointment for CA is no pain, and it doesn't need an anesthesia. We present a case of anal and perianal CA in a 2 years old boy that was treated successfully with Korean Medicine, with no recurrence during the follow up 3 months.

• Journal of the Korean Society of Radiology
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• v.84 no.3
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• pp.565-585
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• 2023

Perianal fistula is a common inflammatory condition in the general population and affects the area around the anal canal. Although most cases are benign, they cause serious morbidity and require surgical treatment due to a high risk of recurrence. MR imaging is a gold standard technique for the evaluation of perianal fistulas and provides accurate information on the anatomy of the anal canal, its relationship to the anal sphincter complex, accurate identification of secondary tracts or abscesses, and reporting associated complications. MR imaging can help monitor treatment effects and determine treatment methods. Crohn's disease-related fistulas often require medical rather than surgical treatment. The radiologist is required to know the anatomy and MR imaging findings of the perianal fistula to present an accurate diagnosis to the clinician.

• The Korean Journal of Pain
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• v.12 no.2
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• pp.217-220
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• 1999

Background: Transcutaneous Electrical Nerve Stimulation (TENS) has been widely used for pain relief after surgery instead of opioid analgesics therapy. This study was designed to study the effectiveness of TENS on perianal pain after anal surgery. Methods: Forty-eight patients who underwent anal surgery were evaluated in this suudy. Caudal anesthesia with 1.5% lidocaine 30 ml mixture 1：200,000 epinephrine was performed. TENS was done at 100 Hz for 25 min. duration, postoperatively at 4 hrs and 24 hrs. Pain was also measured at the 4 hrs and 24 hrs postoperatively by visual analogue scale (VAS). VAS value were compared before and after TENS application. Results: Values of VAS after TENS were significantly lower compared to those before TENS. Conclusions: From these results, we concluded, TENS may be effective for postoperative perianal pain relief after anal surgery.

• Journal of Veterinary Clinics
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• v.36 no.6
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• pp.349-352
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• 2019

A five-year-old female Yorkshire Terrier dog presented with a perianal mass. Fine needle aspiration revealed that the mass comprised two different types of cells: hepatoid epithelial cells and melanin-containing melanocytes. Histopathological examination confirmed perianal gland adenoma with malignant melanoma. Evidence of metastasis was found on thoracic radiography with soft-tissue densities observed within the pulmonary parenchyma. The dog survived for three months after diagnosis of malignant melanoma. This report describes the clinical findings, diagnostics used, cytological and histopathological findings, and the potential prognosis for a dog diagnosed with malignant anal sac melanoma.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.1
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• pp.70-75
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• 2005

Crohn's disease of the perineum is notably resistant to treatment. We describe our experiences of tacrolimus ointment application in three patients with intractable perianal Crohn's disease. At the time of diagnosis patients showed anal fissure with ulcer, anal fistula, or perianal abscess, respectively. These lesions did not respond to steroid, metronidazole, mesalazine, or azathioprine, though the pediatric Crohn's disease activity index was markedly improved during the treatment period (4 to 12 months). Topical tacrolimus was applied and resulted in marked healing and a rapid granulation of cavity edges within 6 weeks to 3 months. Topical tacrolimus at a low dose shows a promise for the management of childhood perianal Crohn's disease. Further controlled studies are required to assess the efficacy and safety of this treatment.

• 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.

• Journal of Veterinary Clinics
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• v.21 no.2
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• pp.187-190
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• 2004

A mixed case of multiple sebaceous gland adenoma and perianal gland adenoma was found in a 11-year-old male Shih Tzu dog. Grossly, many masses less than 1 cm in diameter of back skin and single red-brown mass about 0.5 cm in diameter of inner ear were noted. In addition one of light-pink mass 5 cm in diameter was presented in the anus. All of the masses were well demarcated and dome-shaped or papillated nodules. Histologically, the mass from back and ear were composed with multiple irregular shaped or sized lobules of sebaceous glands. Masses were containing mostly mature sebaceous cells and multifocal cystic degeneration with acellular and bright eosinophilic materials. And the mass from peri-anal area was well-circumscribed and composed of broad, anastomosing trabeculae of well-differentiated hepatoid cells. There were very low mitotic figures in all masses. Based on these results, this case was diagnosed as the multiple sebaceous gland adenoma and perianal gland adenoma.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.59-63
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• 1999

Background: Contraction of anal sphincter muscle produces severe pain in perianal surgery postoperatively. Recent reports have indicated that effective and prolonged pain relief can be obtained by the injection of small doses of morphine into the subarachnoid space. We attempted to use this technique for perianal surgery and investigated postoperative pain control and its side effects. Methods: Forty five patients scheduled for hemorrhoidectomy and anal fistulectomy were studied to determine the minimal effective dose of intrathecal morphine for postoperative analgesia. In order to control the pain, 7 mg of 0.5% hyperbaric bupivacaine with 0.05 mg (group I), 0.1 mg (group II) and 0.15 mg (group III) of morphine hydrochloride was injected with a 25 gauge spinal needle into the subarachnoid space. We estimated the duration of analgesia until the pain score attained to above 3 in 10 cm VAS (visual analogue scale) and incidence of itching, nausea and vomiting by percentage, headache, backpain and respiratory depression by positive and negative. We also checked the time of self-voiding. Results: The mean time of analgesia was $10.3{\pm}1.54$, $19.7{\pm}2.22$ and $20.3{\pm}2.29$ hours in group I, II and III respectively. Urinary retention of group I, II and III after block persisted for an average of $20.3{\pm}2.31$, $21.2{\pm}2.51$ and $23.3{\pm}3.74$ hours. Nausea and vomiting were observed 33%, 53%, 67% and itching was observed 53%, 67%, 80% in group I, II and III respectively and respiratory depression did not occur in all groups. Conclusions: It is not necessary to use more than 0.1mg of intrathecal morphine in perianal surgery because analgesia is not prolonged and side effects are increased.