Acquired anorectal disorders

Abstract Acquired anorectal disorders comprise a disparate group of conditions that are a frequent cause of referral to the paediatric surgical outpatient clinic. Reassurance and conservative management are often all that is necessary, as many conditions such as anal fissure will resolve without surgical intervention if the underlying condition, such as constipation, can be addressed. Some, such as rectal prolapse and visible external ‘piles’, are age-related, reflecting inherent differences in anatomy and physiology that resolve with time. Operative management is, however, indicated in a number of conditions, including perianal abscess and fistula-in-ano, where drainage of a collection of pus and laying open of a fistula are essential to prevent ongoing localized sepsis. Persistent rectal prolapse, usually in an older child, may also warrant surgical intervention.