WOFAPS 2025 8th World Congress of Pediatric Surgery

Hideaki Sato, Miri Tominaga, Sei Adachi, shouta kimura, Syunsuke Oosawa, Noriyoshi Nakayama, Ai Tayama, Yu Watarai

Showa medecal university school of medicine, Department of Surgery, Division of pediatric surgery

Aim

Perianal abscess (PA) is a common disease with a high risk of recurrence. This study aimed to longitudinally evaluate perianal abscesses using high-resolution ultrasonography to predict recurrence.

Methods

The records of 38 patients with PA admitted between 2022 and 2024 were reviewed by comparing their age, treatment, ultrasound findings, and prognosis.

Results

The patent’s mean age was 4.94 months. The initial treatment was puncture in 7 cases, administration of the Kampo medicine “Hainou-sankyu-tou” (TJ122) in 26 cases, “Jyuzen-daiho-tou” (TJ48) in 3 cases, and observation in 2 cases. Ultrasonography using a 33MHz Probe was performed in 17 initial cases for longitudinal follow-up. Ultrasound findings of abscess were classified into 6 groups: low uniform echoic area (LU), iso uniform echoic area (IU), low/iso mixed echoic area (LIM), low/high mixed echoic area (LHM), iso/high echoic area (IHM), and low/high/iso mixed echoic area (LHIM). 3 of 4 in LU, 2 of 2 in IU, 1 of 4 in LIM, and 1 of 4 in LHIM cause recurrences. In patients aged <5 month, the main initial findings were LU (3), IU (2), LIM (3), LHIM (1), IHM (1), and LHIM (3), and the recurrence cases were LU (3), IHM (1). In 6-10 month group, LU, LIM, LHM, and LHIM had one in initial, whereas LIM had 3 in the recurrence. In cases where external findings included scar formation, abscess interiors were classified as LU (1), IU (10), LIM (18), and IHM (3) cases.7 of the 18 LIM cases experienced at least one recurrence.

Conclusion

Patients aged <5 months formed LU at initial and recurrence, with a risk of recurrences. Although the perianal abscess appearance had been scar formation, ultrasound findings revealed the possibility of recurrences especially including low echoic area.