Pediatric proctologic problems occur with sufficient frequency in medical practice to demand special consideration. Schapiro1 reported 2700 pediatric proctologic disorders at a general hospital, representing 2.34% of the total pediatric admissions over a 35-year period. Although the literature is replete with material concerning the management of anal fissure, we were prompted to report our series because of the inadequate, though vigorous, therapy that is frequently rendered the pediatric patient. We hope that, by our presenting all facets of the problem, a greater understanding will be achieved and treatment will improve. Five hundred consecutive pediatric proctologic cases were reviewed from our combined practices. A statistical summary of the varied disorders is presented in the Table.
Incidence and Pathogenesis
It can be seen from the table that 206 patients, or 41%, suffered from anal fissure. There were 81 boys and 125 girls. Our figures correspond approximately to those of Mentzer2 and
ALEXANDER RM, MANHEIM SD. Anal Fissures in Infants and Children. AMA Am J Dis Child. 1958;96(1):29-31. doi:10.1001/archpedi.1958.02060060031005