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Perianal abscess
Causes of perianal abscess formation in babies
In pediatric outpatient surgery, perianal abscesses are not uncommon, and many parents visit the hospital daily for this issue. They wait, register, and change dressings. Once the wound heals, it often recurs after a while, leading to repeated incisions and drainage, persisting for several months. Eventually, the doctors say a fistula has formed and surgery is required. What exactly causes such troublesome perianal abscesses? The cause of perianal abscesses is not completely clear, but many affected children have been found to have deeper anal crypts than normal, so it's speculated that it may be related to this abnormality. In children under two years old, perianal abscesses mostly occur in boys. Some studies suggest that testosterone levels are higher in boys aged 1-3 months, coinciding with a peak period for perianal abscess incidences, leading to speculation that it may be related to the child’s hormone levels. In children over two years old, there is less gender bias in the incidence of perianal abscesses, and some cases are secondary to Crohn’s disease.
How to find the internal opening of a perianal abscess?
The internal opening of a perianal abscess is mainly identified through digital rectal examination and with the aid of a probe and perianal ultrasonography. Typically, during the onset of a perianal abscess, there is noticeable redness, swelling, heat, and pain around the anus. Inside the anal canal, digital rectal examination and anoscopy reveal swollen mucosa at the anal crypt, accompanied by the discharge of pus. Using a probe for exploration can clearly identify the presence of the internal opening locally. Once the internal opening of a perianal abscess is located, prompt surgical treatment is necessary. Surgery for perianal abscesses generally involves a one-time radical procedure complemented by incision and drainage. If an internal opening exists and involves the sphincter, further surgery involving incision, drainage, and seton placement may be required.