Fistula in ano in infants: who recurs?

Pediatr Surg Int. 2008 Nov;24(11):1197-9. doi: 10.1007/s00383-008-2236-3.


Introduction: Fistula in ano is a common malady in infancy. However, relatively little literature is devoted to it. Our aim was to describe the natural history and identify predictors of which children will ultimately recur.

Methods: A retrospective review of patients less than 3 years old undergoing anal fistulotomy was performed between May 2002 and November 2007 at a tertiary children's hospital. Demographics, preoperative, operative, and postoperative characteristics were collected in each group and evaluated by biostatistical analysis. P values <0.05 were considered significant.

Results: A total of 92 children undergoing anal fistulotomy were identified. The median age was 6 months. Twelve children (13%) had recurrences and two of the 12 had multiple recurrences. Children who had recurrences were older (12.9 vs. 7.5 months, P < 0.05) and were more likely to have a previous abscess (20 vs. 6%, P < 0.05). In addition, children with recurrences had pus noted at the time of surgery more than children who did not recur (23 vs. 8%, respectively, P < 0.05). There were no major complications.

Conclusions: Fistula in ano in infants is a relatively benign process with most children having no serious sequelae. However, a not insignificant portion (13%) of children developed recurrences. Older children who developed fistulas were more likely to have a recurrence than younger, and children who had previous episodes of perianal abscess or pus noted at the time of surgery were more likely to recur.

MeSH terms

  • Child, Preschool
  • Female
  • Fissure in Ano / epidemiology*
  • Fissure in Ano / surgery
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Recurrence
  • Retrospective Studies
  • Statistics, Nonparametric