What is Perirectal Abscess?
This is an infection that appears as a tender red lump under the skin near the anus. This lump can grow large and become painful. This type of abscess happens most often in babies and children under a year of age. It may drain fluid (pus) on its own and then heal and disappear. An abscess that does not drain by itself may need to be drained in the office by the Pediatric Surgeon.
What is Perirectal Fistula?
Sometimes an abscess will return if a fistula, or tube like connection, forms between the inside of the anus and the skin. Once a fistula forms, bacteria from the intestine becomes trapped and causes the infection to return. This is called a perirectal fistula. If your child has a perirectal fistula the Pediatric Surgeon may recommend an operation called a fistulectomy to remove the fistula.
How is perirectal abscess treated?
An abscess that does not drain by itself may need to be drained in the office by the Pediatric Surgeon. This may be all that is needed to help the abscess heal permanently. The physician may also prescribe antibiotics for your child.
How is a fistulectomy performed?
If your child has a perirectal fistula, a fistulectomy may be recommended to permanently remove the fistula. During this operation the fistula is removed through a small incision into the side of the anus with the abscess. This is an operation that is done as an outpatient and takes less than one hour. After the operation, your child can go home as soon as he or she is awake and able to drink liquids.
The incision that is made during the fistulectomy is left open and not closed with stitches. This open wound will heal and close by itself in one to two weeks. While the area is healing, no infection will occur in the wound, even though your child has bowel movements. You can help keep the area clean by giving your child a warm bath after every bowel movement. An antibiotic is not needed at this time.
In most appendectomy operations, there is very little blood loss. You child will receive blood only in the rare case of an extreme emergency. If you wish to provide a directed donation of blood, contact our office, 1-2 weeks in advance of the operation.
If the abscess is drained by the surgeon, we suggest that your care at home include warm baths after each bowel movement. This will clean and soothe the area while it is healing. The physician may also prescribe antibiotics for your child.
Fistulectomy incisions are left open and not closed with stitches. This open wound will heal and close by itself in one to two weeks. While the area is healing, no infection will occur in the wound, even though your child has bowel movements. You can help keep the area clean by giving your child a warm bath after every bowel movement. An antibiotic is not needed at this time.
Prescription pain medication is not routinely required after this operation. Children usually only need Acetaminophen (Tylenol®) or Ibuprophen (Motrin®) once they are at home. Follow the dosage directions on the label.
Care for Dressings
After the operation there may be a small dressing to remove from the area. The surgeon will tell you when to remove the dressing, if one is present. If the dressing falls out on it's own before that time, it will not need to be replaced.
Your child may bathe immediately after surgery.
There are no specific activity restrictions following surgery.
Do I see the surgeon again after the operation?
If all is going well, a visit to our office may not be required. Our pediatric nurse practitioner will call you to check on your child's recovery. In some cases, even after a successful operation and careful care at home, it is possible for an abscess or fistula to come back in a different area. If this happens, you will need to return the office for a visit with the Pediatric Surgeon.
When do I call the surgeon's office?
Call our office at 415-476-2538 for the following:
- Any concerns you have about your child's recovery
- A temperature of 101°F or higher
- Increasing pain and tenderness at the incision