Effectiveness of hainosankyuto and juzentaihoto for Abdominal Wall Abscess at the Gastrostomy Site in a Child With Severe Motor and Intellectual Disabilities

Abstract

The traditional herbal Japanese medicine, hainosankyuto, has drainage and anti-inflammatory activities and is considered to be useful for treating perianal abscesses in pediatric surgery. If an abscess becomes chronic, juzentaihoto, another traditional herbal Japanese medicine with wound healing activity, is also considered as a suitable treatment for this condition. A 7-year-old boy had symptomatic epilepsy and spastic quadriplegia in infancy, which made oral intake difficult. At 5 years of age, he underwent gastrostomy but subsequently experienced repeated bouts of dermatitis around the gastrostomy site. Treatment included ointments and skin protective agents; however, the dermatitis worsened from approximately 7 years of age. Abdominal computed tomography (CT) at 7.5 years of age revealed an abdominal wall abscess. The administration of 0.3 g/kg/day hainosankyuto was initiated, after which the amount of exudate decreased and skin inflammation subsided within 1 month. Thereafter, treatment was switched to 0.3 g/kg/day juzentaihoto, which additionally reduced granulation. Abdominal CT after 4 months of treatment showed a remarkable improvement of the abdominal wall swelling and the disappearance of skin inflammation. We report favorable results achieved by administering hainosankyuto and juzentaihoto to a child with severe motor and intellectual disabilities whose treatment became difficult after the formation of an abdominal wall abscess owing to dermatitis around the gastrostomy site.