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 curreTage 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.

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.