Anorectal Disorders

Perianal Abscess- common in infants, this presents as a tender mass noted by the parent at the time of diaper change.  Stooling history is normal.  Treatment is with warm Sitz baths and oral antibiotics such as Augmentin.  One third resolves without further treatment.  The others progress to fluctuance and drain spontaneously or require incision and drainage.  In those that drain, approximately half will go on to form fistulas.

 

Fistula in Ano-This occurs primarily in males after perianal infection.  Chronic drainage is reported by the parent.  The punctum of the fistula tract can be seen and is usually lateral to the anus.  Treatment is by fistulectomy performed as an outpatient.  The wound is left open to heal by secondary intention.

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