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Background <p>Perianal abscesses and anal fistulas are relevant conditions in pediatrics, which represent a&#xa0;significant physical and emotional burden for affected children and their parents.</p> Objective <p>This study provides an overview of the pathogenesis, clinical presentation, diagnostics and treatment of perianal abscesses and fistula in ano in children and adolescents.</p> Material and methods <p>A&#xa0;selective literature search was conducted to provide a&#xa0;comprehensive summary of the current state of knowledge, incorporating basic research, expert recommendations, and recent developments in the field.</p> Results <p>Perianal abscesses and anal fistulas predominantly occur during infancy, with boys being more frequently affected than girls. In children, fistula in ano typically develops idiopathically or as a&#xa0;result of acute infections and a&#xa0;congenital origin is probable. In infants, the condition is often self-limiting, with conservative management proving effective in most cases. From school age onwards, perianal abscesses and fistula in ano are frequently an initial manifestation of Crohn’s disease. Consequently, a&#xa0;thorough medical history is essential and the indications for further diagnostic evaluation should be pursued with a&#xa0;low threshold. Surgical options include the placement of vessel loops or seton sutures, fistulotomy and fistulectomy.</p> Conclusion <p>Age-appropriate diagnostics and treatment are crucial to avoid overtreatment and to prevent complications such as recurrent abscesses or chronic courses. In infants, overtreatment should be avoided. If conservative treatment fails, placement of a&#xa0;non-cutting seton is the treatment of choice.</p>

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Perianale Abszesse und Analfisteln bei Kindern und Jugendlichen

  • 期刊论文

  • 发表日期：

    2025年4月24日

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  • S. Drossard,
  • Thomas Meyer

摘要

Background

Perianal abscesses and anal fistulas are relevant conditions in pediatrics, which represent a significant physical and emotional burden for affected children and their parents.

Objective

This study provides an overview of the pathogenesis, clinical presentation, diagnostics and treatment of perianal abscesses and fistula in ano in children and adolescents.

Material and methods

A selective literature search was conducted to provide a comprehensive summary of the current state of knowledge, incorporating basic research, expert recommendations, and recent developments in the field.

Results

Perianal abscesses and anal fistulas predominantly occur during infancy, with boys being more frequently affected than girls. In children, fistula in ano typically develops idiopathically or as a result of acute infections and a congenital origin is probable. In infants, the condition is often self-limiting, with conservative management proving effective in most cases. From school age onwards, perianal abscesses and fistula in ano are frequently an initial manifestation of Crohn’s disease. Consequently, a thorough medical history is essential and the indications for further diagnostic evaluation should be pursued with a low threshold. Surgical options include the placement of vessel loops or seton sutures, fistulotomy and fistulectomy.

Conclusion

Age-appropriate diagnostics and treatment are crucial to avoid overtreatment and to prevent complications such as recurrent abscesses or chronic courses. In infants, overtreatment should be avoided. If conservative treatment fails, placement of a non-cutting seton is the treatment of choice.