Advances in Pediatric Surgery

"Anal fistula"

Original Articles

[English]

Clinical Characteristics That Led to Diagnosis of Crohn’s Disease After Anal Fistula Surgery in Patients Aged 10–19 Years: A Single Center, Retrospective Study: Ah Young Kang, Ki-Yun Lim, Keehoon Hyun, Heecheol Chang; Adv Pediatr Surg 2024;30(2):64-72. Published online December 10, 2024; DOI: https://doi.org/10.13029/aps.2024.30.2.64

Abstract
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Purpose
Crohn’s disease (CD) is mainly presenting gastrointestinal symptoms but also may involve perianal diseases, with anal fistula being the most common. Anal fistula surgery performed without recognition that the patient has CD increases the complications such as delayed wound healing and anal sphincter injury. This study aimed to investigate clinical symptoms and surgical findings that could allow early diagnosis of CD in patients aged 10 to 19 years who underwent anal fistula surgery.
Methods
Among the 320 patients under the age of 19 who underwent anal fistula surgery, those who were diagnosed with tuberculosis fistula were excluded, medical records of 316 patients were examined. We investigated the characteristics of anal fistula and postoperative wounds as well as the colonoscopic and surgical findings.
Results
Compared to 272 patients not diagnosed with CD (non-CD group), 44 patients diagnosed with CD (CD group) showed significantly higher levels of C-reactive protein as well as anal discharge, family history of inflammatory bowel disease, history of anal fistula, diarrhea, abdominal pain, weight loss, complex anal fistula, recurred anal fistula, delayed wound healing and friable/edematous/granulation of surgical site.
Conclusion
For patients aged 10–19 years with anal fistulas, emphasizing early suspicion and an active diagnostic work-up is essential for early diagnosis of CD.

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[English]

Anal Fistula and Perianal Abscess in Pediatric and Adolescent Patients: Seong Chul Kim, Jin Cheon Kim, In Koo Kim; J Korean Assoc Pediatr Surg 1995;1(1):40-45. Published online June 30, 1995; DOI: https://doi.org/10.13029/jkaps.1995.1.1.40

Abstract
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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 preponderence, 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 (<15 year-old) and sixteen adolescent patients(≥ 15, < 25 year-old) with anal fistula and perianal abscess were treated by surgical intervention. 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 fistulectomy in all the 14 patients. The importance of effective drainage of perianal abscess and fistulotomy including internal opening cannot be overemphasized.