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Is Surgery Required To Cure Congenital Perianal Fistula In A Newborn?

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Posted on Sat, 30 Jun 2012
Question: I would like to know about congenital perianal fistula in newborn, whether surgery is required to cure?
doctor
Answered by Dr. Hema Yadav (2 hours later)
Hello Syam ,
Thanks for posting your query.
Fistulas in infants are usually congenital and are more common in boys than girls.
In a Congenital perianal fistula there is a communication usually between the anal canal and the perineal skin however the fistulous tract may extend from the anal canal to the urethra.
This condition is usually effectively treated by surgery unless underlying bowel disorder complicates it.
The most acceptable and effective treatment is fistulotomy where the tract is excised and primary closure is done.It's a minor surgery and if there are no complications like infection or pus (abscess), imperforate anus etc then recovery is fast and recurrence is negligible.More than 90% cases are cured by such treatment.Though the recurrence and complications rate will vary from case to case.In addition supportive treatment like oral medications ( antibiotics, stool softeners) might be prescribed.
There are usually no future problems for the child if the anal sphincter is normal .
If left untreated there is a risk of recurrent local infections, perianal abscesses and urinary
infections in the child.

Hope that answers your query.
Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Hema Yadav (12 minutes later)
First of all Thank you so much for providing a detailed explanation. Please let me know whether this surgery is painful and how long have to be hospitalised. As he is only 3months whether the surgery should be done very soon or what?
doctor
Answered by Dr. Hema Yadav (19 minutes later)
Hello ,
Thanks for the follow up .
The surgery is not painful as it is done under anaesthesia and minimal post operative pain may be controlled with analgesics.The number of days of hospital stay would vary from a couple of days to a week depending on the individual case and complications.
The surgery can be done even in neonates so age is not a limiting factor.
Whether your child needs urgent surgery or a trial of conservative management can only be suggested after a thorough evaluation including examination, investigations like ultrasound, mri, blood counts etc and grading of severity of his case.This would be best done by the consulting pediatric surgeon for your child.
Hope I have answered your query.
Wishing your child a speedy recovery and a healthy future.
Regards,
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Hema Yadav

Pediatrician, Infectious Diseases

Practicing since :2005

Answered : 1528 Questions

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Is Surgery Required To Cure Congenital Perianal Fistula In A Newborn?

Hello Syam ,
Thanks for posting your query.
Fistulas in infants are usually congenital and are more common in boys than girls.
In a Congenital perianal fistula there is a communication usually between the anal canal and the perineal skin however the fistulous tract may extend from the anal canal to the urethra.
This condition is usually effectively treated by surgery unless underlying bowel disorder complicates it.
The most acceptable and effective treatment is fistulotomy where the tract is excised and primary closure is done.It's a minor surgery and if there are no complications like infection or pus (abscess), imperforate anus etc then recovery is fast and recurrence is negligible.More than 90% cases are cured by such treatment.Though the recurrence and complications rate will vary from case to case.In addition supportive treatment like oral medications ( antibiotics, stool softeners) might be prescribed.
There are usually no future problems for the child if the anal sphincter is normal .
If left untreated there is a risk of recurrent local infections, perianal abscesses and urinary
infections in the child.

Hope that answers your query.
Regards,