July 9, 2009 | In: ABDOMINAL SURGERY
ANAL FISSURE
14. What is the most common location for idiopathic anal fissure?
Show answer
90% are posterior, and 10% are anterior.
15. What are the most common symptoms of anal fissure?
Show answer
Tearing anal pain and bleeding with bowel movements.
16. What is the underlying pathophysiology of fissure in ano?
Show answer
Local trauma to the anal canal, internal anal sphincter dysfunction, and ischemia.
17. What is the differential diagnosis for anal fissure, especially if atypical in location?
Show answer
Anorectal abscess, thrombosed hemorrhoid, inflammatory bowel disease, or malignancy.
18. How do you best diagnose anal fissure?
Show answer
By clinical history and visual inspection-not by digital examination or anoscopy (which serves only to turn a friendly patient into an irate one).
19. What are the nonoperative treatment options?
Show answer
High-fiber diet; stool-bulking agents; increased hydration; frequent, warm sitz baths; and topical agents containing anti-inflammatory agents, local anesthetics, and vasodilators (nitroglycerin).
20. What is the most common operation performed to treat intractable fissure in ano?
Show answer
Fissurotomy with lateral internal anal sphincterotomy.
KEY POINTS: ANAL FISSURE
1. Ninety percent of idiopathic anal fissures are posterior and 10% are anterior.
2. The most common symptoms are tearing anal pain and bleeding with bowel movements.
3. The diagnosis involves visual inspection-not by digital exam or anoscopy.
4. Nonoperative treatment includes high-fiber diet, warm sitz baths, and topical agents containing anti-inflammatory agents, local anesthetics, and vasodilators.
5. The most common operation is a fissurotomy with lateral internal anal sphincterotomy.
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[...]very few websites that happen to be detailed below, from our point of view are undoubtedly well worth checking out[...]……
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February 8th, 2012 at 9:03 am
Great website…
[...]we like to honor many other internet sites on the web, even if they aren’t linked to us, by linking to them. Under are some webpages worth checking out[...]……
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February 8th, 2012 at 10:17 am
Cool sites…
[...]we came across a cool site that you might enjoy. Take a look if you want[...]……
Scott Tucker Racing
February 8th, 2012 at 3:25 pm
Sites we Like……
[...] Every once in a while we choose blogs that we read. Listed below are the latest sites that we choose [...]……
Scott Tucker Racing
February 8th, 2012 at 6:47 pm
Sources…
[...]check below, are some totally unrelated websites to ours, however, they are most trustworthy sources that we use[...]……