• Advances in pediatric surgery
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• v.1 no.1
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• pp.40-45
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• 1995

Anal fistula and perianal abscess in pediatric patients have been reported to have several characteristics, e.g. prevalent in less than 2 years of age, male preponderance, straight course of tract, and low type of fistula. We performed a retrospective study of twenty nine pediatric patients to see these characteristics comparing with the transitional age group of adolescents. Between June 1989 and December 1993, twenty-nine pediatric (<15year-old) and sixteen adolescent patients(${\geqq}$15, <25 year-old) with anal fistula and perianal abscess were treated by surgical intervention. Perianal abscess and anal fistula in the pediatric group had the predilection for male(100%), age less than two years (72.4%), low type(100%), and lateral localization(87.5%). But the features of the adolescent group were similar to those of adult. Twenty-one(87.5%) and 10(66.7%) enteric bacterial colonies were isolated from 16 pediatric and 11 adolescent patients, respectively. Considering the predominance of low type and the organisms cultured in the pediatric group, crypt-glandular infection seems to be a major preceding event. Incision and drainage were sufficient for cure in 15 among 16 perianal abscesses, and fistulas were cured by either fistulotomy or fistulotomy in all the 14 patients. The importance of effective drainage of perianal abscess and fistulotomy including internal opening cannot be overemphasized.

• Journal of Veterinary Clinics
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• v.21 no.2
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• pp.187-190
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• 2004

A mixed case of multiple sebaceous gland adenoma and perianal gland adenoma was found in a 11-year-old male Shih Tzu dog. Grossly, many masses less than 1 cm in diameter of back skin and single red-brown mass about 0.5 cm in diameter of inner ear were noted. In addition one of light-pink mass 5 cm in diameter was presented in the anus. All of the masses were well demarcated and dome-shaped or papillated nodules. Histologically, the mass from back and ear were composed with multiple irregular shaped or sized lobules of sebaceous glands. Masses were containing mostly mature sebaceous cells and multifocal cystic degeneration with acellular and bright eosinophilic materials. And the mass from peri-anal area was well-circumscribed and composed of broad, anastomosing trabeculae of well-differentiated hepatoid cells. There were very low mitotic figures in all masses. Based on these results, this case was diagnosed as the multiple sebaceous gland adenoma and perianal gland adenoma.

• Journal of Veterinary Clinics
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• v.35 no.6
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• pp.299-301
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• 2018

A 7-year-old intact female Shih-Tzu with chylothorax was presented. Percutaneous popliteal computed tomographic lymphangiography was performed to evaluate the thoracic duct and seek any potential cause of chylothorax. Despite two attempts, visualization of the thoracic duct failed and perianal subcutaneous computed tomographic lymphangiography with injection of iodinated, nonionic water-soluble contrast medium (0.6 ml/kg) was performed. A single branch of intact thoracic duct and dilated and tortuous lymphatics were detected. It was diagnosed as idiopathic chylothorax. Perianal subcutaneous lymphangiography is considered a less-invasive, easy and reliable method to visualize lymphatics in patients with chylothorax.

• Clinical and Experimental Pediatrics
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• v.63 no.7
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• pp.272-277
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• 2020

Background: The optimal management of perianal abscess in children is controversial. Purpose: To evaluate the efficiency of conservative treatment of perianal abscess in children and identify parameters that predict therapy failure. Methods: All cases of children younger than 14 years of age with perianal abscesses between 2001-2016 were evaluated. Results: Of the 113 enrolled patients, 64 underwent subsequent surgery for advanced disease (primary surgery group). Conservative treatment was initiated in 49 patients (primary conservative group) but was stopped because of inefficiency in 25 patients, who were referred for surgery after a median 7.03 days (range, 2 to 16 days). The other 24 patients (48%) initially achieved complete remission after conservative treatment, but 10 were readmitted after a median 34 months (range, 3 to 145 months) with recurrent disease. There were no significant differences in permanent success after conservative treatment between infants (10 of 29, 34%) and older children (4 of 20 [20%], P=0.122). Overall, conservative treatment alone was effective in only 14 of 113 patients. Recurrence after surgery occurred in 16 patients (25%) in the primary surgery group and 11 patients (22%) in the primary conservative group (P=0.75). Univariate analysis of predictors for conservative treatment failure revealed inflammatory values (C-reactive protein and white blood count, P=0.017) and abscess size (P=0.001) as significant parameters, whereas multivariate analysis demonstrated that only abscess size (odds ratio, 3.37; P=0.023) was significant. Conclusion: Conservative treatment of perianal abscess is permanently efficient in only a minority of children but is not associated with a higher recurrence rate after subsequent surgery. Abscess size is a predictor for therapy failure.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.1
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• pp.70-75
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• 2005

Crohn's disease of the perineum is notably resistant to treatment. We describe our experiences of tacrolimus ointment application in three patients with intractable perianal Crohn's disease. At the time of diagnosis patients showed anal fissure with ulcer, anal fistula, or perianal abscess, respectively. These lesions did not respond to steroid, metronidazole, mesalazine, or azathioprine, though the pediatric Crohn's disease activity index was markedly improved during the treatment period (4 to 12 months). Topical tacrolimus was applied and resulted in marked healing and a rapid granulation of cavity edges within 6 weeks to 3 months. Topical tacrolimus at a low dose shows a promise for the management of childhood perianal Crohn's disease. Further controlled studies are required to assess the efficacy and safety of this treatment.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.29 no.2
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• pp.180-186
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• 2016

Anal and perianal condyloma acuminatum(CA), which is a large cauliflower-like tumor, is a manifestation of human papillomavirus (HPV) infection. HPV may be acquired via sexual transmission, vertical transmission or nonsexual contact. It is an uncommon condition in children but the incidence in children has been increasing recently. There are many therapies for CA including chemical or physical destruction, immunological therapy, or a surgical excision. All these procedures have some degree of limitations such as limited clearance rate, high recurrence rate, pain, bleeding, release of potentially infectious aerosols and scar. It may be traumatic mentally to the children as well as physically. Korean Medicine included herbal treatment and herbal ointment for CA is no pain, and it doesn't need an anesthesia. We present a case of anal and perianal CA in a 2 years old boy that was treated successfully with Korean Medicine, with no recurrence during the follow up 3 months.

• Journal of the Korean Society of Radiology
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• v.84 no.3
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• pp.565-585
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• 2023

Perianal fistula is a common inflammatory condition in the general population and affects the area around the anal canal. Although most cases are benign, they cause serious morbidity and require surgical treatment due to a high risk of recurrence. MR imaging is a gold standard technique for the evaluation of perianal fistulas and provides accurate information on the anatomy of the anal canal, its relationship to the anal sphincter complex, accurate identification of secondary tracts or abscesses, and reporting associated complications. MR imaging can help monitor treatment effects and determine treatment methods. Crohn's disease-related fistulas often require medical rather than surgical treatment. The radiologist is required to know the anatomy and MR imaging findings of the perianal fistula to present an accurate diagnosis to the clinician.

• Journal of Veterinary Clinics
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• v.38 no.5
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• pp.240-243
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• 2021

Complications of pelvic fractures and sacroiliac joint luxation include hemoabdomen, pulmonary trauma, and soft tissue injury. Among them, rectal perforation accounts for 1% of pelvic fracture complications. Delayed diagnosis is commonly associated with a poor prognosis. A mixed-breed dog was presented to Jeonbuk Animal Medical Center (JAMC) after a traffic accident with no signs of rectal perforation. After fracture surgery, rectal perforation was seen as a perianal fistula. This report describes a case of a perianal fistula progressed from rectal perforation after a traffic accident that was curatively treated with lateral caudal axial pattern flap surgery to the perianal skin.

• Journal of Life Science
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• v.18 no.2
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• pp.279-283
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• 2008

A 12.6-year-old, male Shitzu was diagnosed with perianal adenocarcinoma. The presented mass was brown to black, $4{\times}3{\times}3cm$ in size, and yellowish on cut section. Microscopic findings revealed that the mass composed of variable sized clusters of hepatoid cells with inconspicuous distinct. The tumor cells were polyhedral and pyknotic and exhibited high mitotic activity. Tumor cells intermingled with basaloid cells and primitive cells invaded the adjacent normal tissues. Basaloid cells exhibited positive immunoreactivity for Epidermal growth factor receptor (EGFR), human epidermal growth factor receptor (HER-2/neu), matrix metallopnateinase 9 (MMP-9), and perianal adenocarcinoma, protein kinase C alpha (PKC ${\alpha}$). Generally, tumors of the perianal gland are common and benign 4.5 times more often than carcinoma in the dog, particularly in males. In the present report, we examined histopathological and immunohistochemical characteristics of a rare perianal adenocarcinoma in association with proteins involved tumor metastasis and adenocarcinoma development.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.59-63
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• 1999

Background: Contraction of anal sphincter muscle produces severe pain in perianal surgery postoperatively. Recent reports have indicated that effective and prolonged pain relief can be obtained by the injection of small doses of morphine into the subarachnoid space. We attempted to use this technique for perianal surgery and investigated postoperative pain control and its side effects. Methods: Forty five patients scheduled for hemorrhoidectomy and anal fistulectomy were studied to determine the minimal effective dose of intrathecal morphine for postoperative analgesia. In order to control the pain, 7 mg of 0.5% hyperbaric bupivacaine with 0.05 mg (group I), 0.1 mg (group II) and 0.15 mg (group III) of morphine hydrochloride was injected with a 25 gauge spinal needle into the subarachnoid space. We estimated the duration of analgesia until the pain score attained to above 3 in 10 cm VAS (visual analogue scale) and incidence of itching, nausea and vomiting by percentage, headache, backpain and respiratory depression by positive and negative. We also checked the time of self-voiding. Results: The mean time of analgesia was $10.3{\pm}1.54$, $19.7{\pm}2.22$ and $20.3{\pm}2.29$ hours in group I, II and III respectively. Urinary retention of group I, II and III after block persisted for an average of $20.3{\pm}2.31$, $21.2{\pm}2.51$ and $23.3{\pm}3.74$ hours. Nausea and vomiting were observed 33%, 53%, 67% and itching was observed 53%, 67%, 80% in group I, II and III respectively and respiratory depression did not occur in all groups. Conclusions: It is not necessary to use more than 0.1mg of intrathecal morphine in perianal surgery because analgesia is not prolonged and side effects are increased.