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Clin Colon Rectal Surg 2011; 24(1): 022-030
DOI: 10.1055/s-0031-1272820
© Thieme Medical Publishers

Anal Fissure

Karen N. Zaghiyan1 , Phillip Fleshner2 , 3
  • 1Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California
  • 2Division of Colon and Rectal Surgery, Cedars-Sinai Medical Center, Los Angeles, California
  • 3Department of Surgery, UCLA School of Medicine, Los Angeles, California
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Publication History

Publication Date:
23 February 2011 (online)

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ABSTRACT

Anal fissure is one of the most common anorectal problems. Anal fissure is largely associated with high anal sphincter pressures and most treatment options are based on reducing anal pressures. Conservative management, using increased fiber and warm baths, results in healing of approximately half of all anal fissures. In fissures that fail conservative care, various pharmacologic and surgical options offer satisfactory cure rates. Lateral internal sphincterotomy remains the gold standard for definitive management of anal fissure. This review outlines the key points in the presentation, pathophysiology, and management of anal fissure.

KEYWORDS

Anal fissure - fissure in ano - sphincterotomy - anal sphincter hypertonia