Non-operative Versus Operative Management of Perianal Abscess in Infants: A 10-year Retrospective Study at Two Centres in the United Kingdom
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- Surgical management (I&D under GA) reduces recurrence risk vs non-operative management (antibiotics/bedside drainage) in infant perianal abscess.
- Non-operative management avoids general anesthesia but carries higher risk of abscess recurrence and need for subsequent surgery.
- 43 surgical vs 73 non-surgical patients studied across two UK pediatric centers (2012-2022) in infants <12 months old.
- Treatment decisions should balance surgical/anesthesia risks against recurrence risk on a case-by-case basis.
- First-episode perianal abscess in infants may benefit from upfront surgical intervention to prevent recurrent disease.
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For infants with perianal abscess, it's a better to manage them operatively or non-operatively. I'm Lizzie Lee from Cincinnati Children's Hospital and this is an article you should know about. This retrospective cohort study looked at children less than 12 months old who underwent their first episode of perianal abscess at two pediatric surgery centers in the UK from 2012 to 2022. Forty-three patients were managed surgically with general anesthesia, incision, and drainage with some needing fist-jula treatment as well. 73 patients were managed non-surgically with antibiotics, bedside aspiration, and bedside drainage. They found that the non-operatively managed group of patients had a higher risk of abscess recurrence and needing subsequent surgery, but they did avoid general anesthesia. This study showed the superiority of surgical management for perianal abscess and infants, but decisions should weigh the risks of surgery and anesthesia against the risk of recurrence.