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Anterior anal fissure

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    This chapter provides a summary of the aetiology, diagnosis, investigation and management of anal fissure. It gives an overview of clinical anatomy and pathophysiology related to anal fissure. Focusing on anal sphincter hypertonia as the key factor for anal fissure progression, the chapter draws attention to perpetuating factors that contribute to a vicious cycle of fissure non-healing and addresses management options for these factors. This chapter also looks at the way how different treatment options for anal fissure emerged over time and uses evidence-based medicine to compare these options. Proctological Diseases in Surgical Practice. Anal fissure, also known as fissure-in-ano, is a common cause of perianal pain.
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    Anal Fissure

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    Anal Fissures Article

    An anal fissure is a superficial tear in the skin distal to the dentate line. Anal fissures are common in those with a history of constipation or hard stools, low fiber diet, trauma, and previous anal surgery. Anal fissures can be acute lasting less than six weeks or chronic more than six weeks. The majority of anal fissures occur at either the posterior or anterior midline. Other locations warrant further workup to rule out secondary causes. This activity describes the etiology, clinical features, and types, along with treatment strategies including conservative and surgical procedures and postoperative management, while outlining the lifestyle modifications for preventing recurrences of anal fissures. This activity highlights the critical role of the interprofessional care team in caring for patients with anal fissures and improving long-term outcomes.
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    Anal fissure

    Try out PMC Labs and tell us what you think. Learn More. An anal fissure is a common, mostly benign, condition that can be acute or chronic. The diagnosis is usually made on history and physical examination, but further investigations are sometimes necessary.
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    Objective: The pathogenesis of chronic anal fissure CAF remains incompletely understood but most are associated with a high resting anal pressure and reduced perfusion at the fissure site. To date, no major distinction has been made between anterior and posterior anal fissures and their aetiology and treatment. We compared anterior and posterior fissures in patients who have failed to respond to medical treatment with respect to their underlying aetiology, anal canal pressures and sphincter muscle integrity. Method: Seventy consecutive patients 54 female male with a symptomatic CAF and 39 normal controls 19 female male without evidence of significant ano-rectal pathology were prospectively assessed by manometry and anal endosonography.
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