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An anal fissure occurs when the mucous lining of the anus becomes torn 1 2. About 80 percent of infants develop these fissures before their first birthdays, according to medline plus 1. In some cases, the fissure is a small crack in the skin, but in other cases the only evidence is blood in the babys diaper or diaper wipe. A high incidence of recurrence has been attributed to a congenital abnormality of the anal crypts. To verify this hypothesis, we reviewed all anal fistulas seen in children less than 2 years of age and treated between 19. a fistula is an abnormal communication between two epithelial-lined organs. A f istula-in-ano is a fistulous connection on the body surface near the anus. It is usually secondary to perianal infections (ie, acquired) in rare cases, it is secondary to a congenital defect. In an acquired fistula-in-ano, the communication is typically between the anal canal and the perineal skin. An anal fistula can easily be seen by using hydrogen peroxide in a case. A baby (3-month-old male) was brought with recurrent perianal abscesses and inflammation. The anal fistula was found out during irrigating the abscess cavity with hydrogen peroxide with 24 gauge iv catheter. Anal fistulas in infants are observed exclusively in males and are often related to abnormal crypts. Although 92 of fistulas are preceded by a perianal abscess, only 42 of perianal abscesses will result in fistula formation. Anal fistulas can be treated by either fistulotomy or fistulectomy. the features of perianal abscess and fistula-in-ano in infants are different from those of older children, and there is controversy regarding their treatment. The aim of this study was to assess the efficacy of various methods used for their management. A retrospective analysis of the records was conducted for all infants younger than 24 months of age treated for perianal abscess, fistula-in.