Fissure Flashcards
1
Q
what is an anal fissure?
A
a tear of the epithelium and dermis at the anal margin extending up into the anal canal, but below the dentate line
2
Q
what increases the risk of an anal fissure?
A
- mechanical/traumatic
- hypertonia of internal anal sphincter
- ischaemia
3
Q
what are the risk factors for an anal fissure?
A
- constipation
- low-fibre diet
- opioids
- IBD
- chronic diarrhoea
- pregnancy
4
Q
what are the symptoms of an anal fissure?
A
- painful defecation
- rectal bleeding
- sentinel pile
5
Q
what is the conservative management of an anal fissure?
A
- lidocaine 5% ointment
- lactulose
- high-fibre diet
6
Q
what is the medical management of an anal fissure?
A
- glyceryl trinitrate ointment
- topical calcium channel-blocker (e.g. diltiazem)
- EUA + botulinum toxin injection
7
Q
what is the surgical management of an anal fissure?
A
- lateral internal sphincterotomy
- fissurectomy
8
Q
what are the long-term complications of an anal fissure?
A
- infection
- fistulation
- anal stenosis
