Anal fissure Flashcards
1
Q
What is an anal fissure?
A
This is a split in the skin of the distal anal canal characterised by pain on defecation and rectal bleeding.
2
Q
Which age group is anal fissure most common?
A
A common condition in young-middle-aged adults
Second commonest GI complication of pregnancy after haemorrhoids
3
Q
Characteristic of anal fissure pain
A
Often described as ‘like passing broken glass’
4
Q
Signs and symptoms of anal fissure
A
Pain on defecation Tearing sensation on passing stool Fresh blood in the stool or on paper Anal spasm Intermittent symptoms Sentinel pile
5
Q
Risk factors of anal fissure
A
Hard stool
Pregnancy
Opiate analgesia
6
Q
Investigations of anal fissure
A
Clinical diagnosis (no tests usually required) Anal manometry Anal ultrasound
7
Q
Differentials of anal fissure
A
Crohn's disease Sarcoidosis TB Anal carcinoma HIV Lymphoma Syphilis
8
Q
Management of anal fissure
A
-Conservative treatment (high-fibre diet, adequate fluid intake, topical analgesia) Topical glyceryl trinitrate Topical diltiazem -Resistant fissures- Botulinum toxin injection Surgical sphincterotomy Anal advancement flap
9
Q
Complications of anal fissure
A
Recurrence
Chronic anal fissure
Incontinence after surgery
