Conservative management of fistula in ano in infants
Yasuhiro Watanabe, Takuji Todani, Sae Yamamoto
Pediatr Surg Int 13: 274-276, 1998
We analyzed the natural course of fistula in ano (FIA) and/or perianal abscess
(PAA) in 97 children (male: 90, female: 7) and recommend conservative management
in infants. Nearly one-half of these children had no recurrent episodes,
and 80% of the infants recovered spontaneously within their 1st year of
life. A radical operation was required in only 6 children after 2 years
of age. Two-thirds of the children with a PAA did not develop fistula. Of
the children who developed FIA, 42% had no recurrence. Although the duration
of FIA was relatively longer than that of PAA, 55% of the children were
cured within 1 year. PAA and/or FIA in infants is likely to be a period-limited
disorder that occurs mainly in infancy and spontaneously resolves within
1 year of life. Fistulotomy or fistulectomy should be avoided in infants.
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