Can a perianal abscess in children heal by itself?

Written by Li Jiao Yan
Neonatology
Updated on September 21, 2024
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Although they are all perianal abscesses, each child's condition is different. The size of the perianal abscesses varies; some are as small as a grain of rice and may heal on their own, but there are also larger ones the size of a walnut, or even cause the entire buttock area to become swollen and red. Such cases require hospitalization, especially for younger children who also exhibit systemic symptoms like fever. They generally require hospital treatment. Meanwhile, it is recommended that parents take good care of the baby's perianal area, maintain a healthy diet and bowel habits, avoid diarrhea and constipation, ensure cleanliness around the anal area, and use soft, non-irritating wet wipes when cleaning the area to avoid friction injuries that could lead to infections, as the skin of small infants is very delicate.

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Written by Chen Tian Jing
Colorectal Surgery
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Is the recurrence rate of perianal abscess high?

Perianal abscess is an acute infectious disease localized around the anus. If a perianal abscess acutely erupts, it requires prompt surgical treatment. Without surgery, there is a possibility of recurrent episodes of perianal abscesses or the formation of anal fistulas due to the rupture of the abscess. After surgery for a perianal abscess, it is also important to pay attention to a light diet and regular bowel movements. It is crucial not to allow the stool to become too dry, nor to experience diarrhea. Recurrent diarrhea can lead to infection of the anal crypts, thereby causing perianal abscesses and local infections. Therefore, the care of a perianal abscess is very important; maintaining good dietary and bowel habits is essential to prevent recurrence of the abscess.

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Written by Chen Tian Jing
Colorectal Surgery
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What should not be eaten with a perianal abscess?

During the acute phase of a perianal abscess, it is not advised to consume overly spicy and stimulating foods, drink alcohol, or eat much lamb, seafood, and other aggravating items. This is because a perianal abscess is a local infectious disease around the anus. Therefore, it is necessary to undergo surgery as soon as possible during an outbreak to prevent the spread of the abscess and increase the difficulty of treatment later. The surgical methods mainly include incision and drainage and one-time radical surgery. However, when there is a local fistula or changes in the sphincter, a fistulotomy with seton placement can also be chosen. Post-surgery, it is crucial to pay attention to the local wound drainage and dressing changes, which are very important for wound healing. It is essential to ensure proper drainage and thorough dressing changes to avoid pseudohealing or recurrent infection of the wound.

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Written by Xiao Zhi Guo
Colorectal Surgery Department
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How to treat perianal abscess?

Perianal abscesses generally have two treatment options. Initially, if the abscess is not very large and the swelling and pain are not particularly severe, conservative treatment with antibiotics can be used temporarily. If conservative treatment is ineffective and the swelling worsens, surgical treatment may be necessary. In cases of severe abscesses, incision and drainage can be considered first, followed by antibiotic treatment. Surgical definitive treatment can then be performed 3-5 days later.

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Written by Chen Tian Jing
Colorectal Surgery
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Anal abscess tight skin tendon pain for a few days

If a perianal abscess undergoes a rubber band ligation surgery, the rubber band may fall off within a week to ten days. If the local rubber band is too loose or takes longer to fall off after surgery, the doctor can further tighten the local rubber band to promote its earlier detachment and ensure the function of the local sphincter around the anus. After tightening the rubber band, the local wound may experience significant pain and minor bleeding due to the pulling of the rubber band. The pain usually lasts about one to two days and will gradually subside as the local wound heals.

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Written by Chen Tian Jing
Colorectal Surgery
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What is causing the stabbing pain in the wound half a year after perianal abscess surgery?

Six months after surgery for a perianal abscess, if there is local pain at the wound site, it is first necessary to rule out the presence of local infection and recurrence. To differentiate between infection and recurrence, it is necessary to conduct a digital rectal examination and a perianal ultrasound to confirm the diagnosis. If infection and recurrence are ruled out, consider the possibility that the pain may be due to contraction and softening of the scar tissue at the site of the perianal abscess surgery, leading to painful stinging at the wound. Local application of anti-inflammatory ointments or gels can be used to treat the inflammation. If the pain or discomfort is severe, Chinese herbal washes or dilute salt water can be used for fumigation and hot compresses on the local scar.