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We present the case of monochronic dizygotic twins with perianal abscesses coincident in chronology and morphology. This image typifies the features of infant perianal disease that suggest a congenital aetiology.
Twin 1 (weight 3.67 kg) and Twin 2 (weight 3.91 kg) were admitted to a tertiary paediatric surgical unit on the 34th day of life following a history of perianal abscess at the 11- and 10- o'clock positions, respectively (figure 1). This photograph was taken on the 35th day of life. Prior to referral, both patients received oral, then intravenous co-amoxiclav with little local improvement. Incision and drainage was carried out on the 39th (Twin 1) and 35th (Twin 2) day of life, respectively. Escherichia coli (Twin 1) and E Coli and Staphylococcus aureus (Twin 2) were cultured from the abscess pus.
Perianal abscesses are found within 2 cm of the anal verge and are relatively common in infants (estimated incidence 0.5–4.3%). Features suggestive of congenital aetiology are as follows:
Competing interests None.
Patient consent Obtained.