Perianal abscess is the collection of inflammation in the skin around the anus, while fistula is the formation of a path between the anus (anus) and the skin, connecting the inner part and the outer part. It is more common under the age of one. It is more common in boys than girls. Babies usually have complaints such as restlessness, fever, crying during defecation. Fistula and abscess occur very close to the anus. In older children, deeper abscesses occur and may be related to the parts of the intestine distal to the anus. Antibiotic treatment can be started depending on the prevalence and whether the patient has additional findings or not. Perianal abscess and fistula development in older children may develop independently of another disease or may occur with many serious diseases. Therefore, laboratory and radiological studies may be required in addition to surgical treatment and wound care in older children.
The treatment of these patients is surgical. If the abscess is mature and the inflammation inside has softened, a small incision is made on it, the inflammation is drained, the inside is cleaned and covered with a dressing. After treatment of the abscess, the abscess may recur or, as in one-third of patients, a perianal fistula develops. Surgery is required in patients with fistula or recurrent abscess. The path associated with the anus is determined with a metal rod advanced through the fistula opening. There are two techniques. In the first, the fistula path is opened and closed with a dressing after cleaning, most of the time the wound lips are not sutured, the wound is expected to close on its own (fistulotomy). Generally, the surgical area in the perianal region heals within 10-14 days. In the second technique, the path is followed and removed to the anal glands, where it ends completely (fistulectomy). It can be left open or removed in a few temporary stitches. Recurrence is less likely but heals later (average 4-6 weeks). Recently, it is also treated with laser. In this technique, less damage is done to the surrounding tissues and better results are obtained in terms of aesthetics.
