Anal Fissure pg 2161 Flashcards
what are linear or rocket shaped ulcers that are usually <5mm in length and located at 6 o clock from Anus?
Anal fissure
What should raise suspicion of sexual assault or more serious disease with anal fissures?
if they occur off midline
believed cause of anal fissures?
trauma to anal canal during defecation, caused by straining, constipation, or high internal sphincter tone.
SX of anal fissures:
severe, tearing pain during defecation followed by throbbing discomfort that may lead to constipation due to fear of recurrent pain (they are weak)
How do acute anal fissures present?
crack in the epithelium
how do chronic fissures present?
they result in fibrosis and the development of a skin tag at the outermost edge
TX for anal fissures:
fiber supplements and sitz bath
topical anesthetic
tylenol or NSAIDS
how long will anal fissures take to heal?
w/in 2 months in up to 45 % of patients with conservative management
How are Chronic Fissures that are referred treated?
topical nitro or diltiazem
botox injections
