Anorectal aspects of pediatric proctology

Summary and Conclusions

I have reviewed the relatively meager information in medical literature on the subject of pediatric proctology. This report is based on this study and my limited experience of eight years on the proctologic service at the Los Angeles Children’s Hospital.

I have tried to emphasize the developmental aspects of pelvirectal anatomy which seem to bear some relationship to proctologic problems of infants and children. Usually the type of rectal bleeding encountered in the out patient proctologic service is of minimal significance and approximately 70 per cent can be diagnosed with little effort.

Management of anal fissures, and abrasions and rectal prolapse should be conservative whenever possible.

Surgical management of fistulas in children is almost always a simple procedure because of the uncomplicated nature of the fistulous tract. The rapid healing power of the young is well known. Most patients are hospitalized for only three days. They require very little analgesia and seem to be undisturbed by evacuation during the postoperative period.

There is no examination which requires more patience, extreme gentleness and tact in order to obtain cooperation and confidence of the fearful child and his worried mother.