The main manifestations of anal fistula in children are as follows: 1. Intermittent, small amounts of purulent discharge can appear from the external opening of the fistula; 2. The skin around the anus can also cause anal itching and severe eczema due to the stimulation of secretions; 3. Larger high anal fistulas may have fecal or gas discharge from the fistula opening; 4. Blockage of the external opening or pseudo-healing fistula with poor pus discharge can also form a perianal abscess, which is manifested as perianal abscess symptoms. The perianal abscess will be temporarily relieved as the abscess breaks down and the pus is discharged, and the abscess repeatedly forms the characteristics of an anal fistula; 5. One or more external openings may appear in the perianal area, with a red papillary projection, and sometimes a small amount of purulent, bloody or mucus discharge from the fistula when pressed, and mild pressure pain at the internal opening of the fistula during rectal auscultation. If the fistula is superficial, the fistula can be felt as a hard nodular internal opening and a fistula with cords.