Infant perianal abscesses and pediatric anal fistulas are not uncommon in clinical practice, especially for infants and children under 6 months of age, and it can be said that the baby’s buttocks affect the whole family. In fact, infant perianal abscess is a common clinical condition in anorectal medicine, and the remedy may not need to be particularly far-fetched. Perianal abscesses in young children are closely related to the immunity, hormone levels, bowel movements and especially possible diarrhea of infants and children, and conservative treatment and incision and drainage in Chinese medicine need to be carefully weighed. Conservative treatment? One-stage surgery? I would like to make a brief analysis and talk about the impact of the timing of treatment on the disease and prognosis in order to help mothers. I. Infant paranal abscess Q & A: Patient: On the morning of March 3, the redness of the hospital clinic, the head of pus could not be seen, and there was no sense of fluctuation, but the doctor squeezed the redness hard, and pus flowed out of the anus, saying that it was an anal fistula. The same day I was admitted to Nanjing Children’s Hospital to cut the row, the drainage strip can not be inserted into the wound, the doctor squeeze pus every day, for 3 days without pus, then do not squeeze. The company’s main business is to provide a wide range of products and services to its customers. But 2 days later it got bigger again, and now it’s even bigger than before the cut, red and hard, without any fluctuating sensation. Is my son already having an anal fistula? I’ve been taking care of him very carefully. What should I do? First, let’s understand how a perianal abscess is formed: there is a tissue structure called the anal sinus at the anorectal junction, where there are anal glands that open upwards. Various causes (mostly related to bowel movements, diarrhea or constipation, some think that infants may have high levels of transient androgens in their bodies) cause the glands to become infected and spread outwards, forming an inflammatory mass that liquefies into pus, the so-called perianal abscess. You may be worried about your baby, but perianal abscesses in infants are indeed a common occurrence, especially in male infants. The diagnosis of your baby’s perianal abscess should be clear, the treatment: when it does not become pus, you can use some herbal creams (the so-called “hoop around the medicine”, ask a Chinese medicine doctor, more than three levels of Chinese medicine hospitals have their own clinically proven hospital preparations, such as our hospital’s Fu Huang cream, hemorrhoid lotion, anti-invasive combination, etc. contains a topical cream, lotion and oral The actual pus is still the principle unless it collapses on its own, and now if it becomes pus again, the larger the incision is, the more adequate the drainage will be (a simple anal incision is sufficient). The baby’s condition may form an anal fistula, but this is not a big deal, which is to be observed and dealt with later. Now you need to observe the local swelling, if it becomes pus should still be promptly disposed of. In addition you are in Nanjing, the city Chinese hospital, the provincial Chinese hospital anorectal department are very good, you can ask a specialist doctor to give some advice. Patient: Hello professor, looking back on the past two months, my son has suffered a lot. Now he can’t feel the lump, it’s soft, but the incision scar is obvious. Is this considered healing? Do I need any more special care? I’m still taking a PP powder bath after each bowel movement. Observe for 6 months, no special treatment is needed now, just live normally and keep the area dry, PP sitz bath is not recommended. Patient: I hope this reply can help those anxious mothers. My son was found to have perianal abscess more than 2 months ago. He has been hospitalized in Nanjing Children’s Hospital, drained, bought the cooling cream from Hangzhou Hospital, and boiled his own Chinese medicine to soak his buttocks. After consulting many doctors online, the one I want to thank is the doctor. He patiently told me about the formation process of perianal abscess and identified my confidence. As long as the mother is patient, the baby will be fine when it matures. Previously, I insisted on soaking PP powder for my son after he had a bowel movement, and I didn’t stop until he was almost 6 months old. Now there is a black mark near the anus because of the soaking PP powder. Looking back at the process, you should listen to the doctor’s advice: now there is no need for special treatment, normal life, keep the local dry on it, it is not recommended pp sitz bath. Now that my son is 13 months old, there is no problem at all. Over each greatly, are washed clean with running water, did not neglect because of the healing. In short, this problem is a test of a mother’s patience and care. Once again, thank you doctor! I am happy to have some help for my child. Indeed looking back on each year, perianal abscesses in infants and children are not uncommon, and I am glad that the majority of children healed successfully. As you said, apart from the timely and accurate treatment by the doctor, this ailment does test the patience of the mothers as well. I’ve pulled the consultation into the classic Q&A section, and I hope it will help more troubled moms. The timing of conservative and incisional abscesses in infants and children needs to be made clear that perianal abscesses in infants and children are different from those in adults, and that a large proportion of abscesses in young children do not eventually form anal fistulas, firstly because most abscesses in young children are superficial, and also because infants and children are at a stage of growth and development and vigorous tissue cell renewal. Some of the fistulas that do form are also rarely complex or high fistulas, and the later management is much easier than in adults. I have seen an extreme case in my clinic of an out-of-town baby girl who was completely ulcerated between the anus and the vagina at the time of the visit, and although the infection was controlled by treatment, the impact on her future could be imagined. Therefore, regardless of the reasons, the management of perianal abscesses in infants needs to be well-timed and decisive. Conservative? Incision? Chinese herbal treatment? One-stage surgery? This is not really a specious question, but it is necessary to be confirmed by an experienced specialist, and the principles of treatment should not be applied emotionally. 1, about conservative treatment: the abscess is not liquefied at the beginning, the abscess is liquefied but confined to the superficial surface, the abscess is not measured in the front, conservative treatment includes antibiotics, basic treatment (such as diarrhea and other treatment); in addition, Chinese medicine treatment does have significant efficacy, clearing heat and detoxifying pus, whether lotion, cream, soup are clinically proven, more than three A Chinese hospital has the corresponding preparation, probably the standard, such as our hospital Fu Huang cream clinical use For example, our hospital has been using Fuhuang Paste for 50 years, and there are dozens of papers on Fuhuang Paste for the treatment of Yang’s swelling and ulcers that can be searched. The same is true for lotions and anti-invasive preparations. Conservative treatment is carried out on the basis of close observation of abscess changes. The characteristics of infant abscesses themselves allow many children to choose conservative, rather than drugs that allow him to choose conservative, otherwise try adult abscesses? 2, on the incision and drainage of pus: there are 5 physiological gaps around the anorectum, the tissue is loose, the gap is full of fat, theoretically, after the pus form needs to have a way out, not to go outside then to the deep to spread around, this is the theoretical basis of drainage well, infant abscesses are more superficial, so often self-collapse, the role of creams taken partly here, so that it is easier to collapse, another part of the role (sometimes combined with The other part (sometimes combined with antibiotics) keeps it confined and does not go deeper. If the pus becomes and does not ulcerate, and the child has an elevated temperature, etc., it must be necessary to cut the drain, without hesitation, and there is nothing to cut it, even without anesthesia, which is done in 1-2 seconds, and the child usually does not react to it. In this way, after the pus is not waiting for him to collapse since it is better to help him collapse? 3.One-stage surgery: For most adult abscesses, we choose one-stage surgery clinically, that is, at the same time of cutting and draining, we find the infected inner mouth and open the cavity between the inner mouth and the cutting and draining mouth, blocking the formation of anal fistula. Infants and children generally only shape the incision, so the pain is only momentary, enough drainage, and the infant abscess is mostly curable.