Anal fissure Flashcards
1
Q
what is an anal fissure?
A
painful tear in squamous lining of lower anal canal
2
Q
Type of pain with anal fissure?
A
often chronic with a ‘sentinel pile’
3
Q
Location of 90% of them?
A
posterior
4
Q
Why is healing difficult?
A
spasm may constrict the inferior rectal artery, causing ischaemia, making healing difficult and perpetuating the problem
5
Q
Rare causes?
A
syphilis, trauma, crohn’s, anal cancer, psoriasis
6
Q
Treatment of anal fissure?
A
5% lidocaine oitment + GTN oitment or topical diltiazen
dietary fibre, fluids, stool softener, hygiene advice
surgery is no other options: lateral partial internal sphincterotomy
