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[Anal fissure].

Nadia Fathallah¹, Lucas Spindler¹, Jean-David Zeitoun²

¹Service de proctologie médico-chirurgicale, groupe hospitalier Paris-Saint-Joseph, Paris, France.

La Revue Du Praticien

|April 3, 2020

Summary

This summary is machine-generated.

Anal fissures are painful conditions affecting young adults, often misdiagnosed as hemorrhoids. While medical treatments offer some success, surgery is reserved for persistent or severe cases, with differing surgical preferences globally.

Keywords:

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Murine Ileocolic Bowel Resection with Primary Anastomosis

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Area of Science:

Proctology
Gastroenterology

Background:

Anal fissure is a common, painful proctological condition impacting quality of life, particularly in young adults.
It typically presents in the posterior anal commissure, sometimes obscured by skin tags, leading to potential misdiagnosis as hemorrhoids.
Atypical presentations necessitate consideration of differential diagnoses including malignancy, Crohn's disease, and infections.

Purpose of the Study:

To summarize the key aspects of anal fissure, including its presentation, pathophysiology, and management.
To highlight the diagnostic challenges and the importance of considering differential diagnoses.
To compare common surgical approaches for anal fissure treatment.

Main Methods:

Review of existing literature on anal fissure pathophysiology and treatment.
Analysis of diagnostic criteria and differential diagnoses.
Comparison of surgical techniques, fissurectomy and lateral internal sphincterotomy.

Main Results:

Anal fissures are frequently linked to hard stool passage and anal hypertonia.
Medical treatment achieves cure in just over half of patients.
Surgical intervention is indicated for treatment failures and hyperalgesic fissures.

Conclusions:

Anal fissure management requires accurate diagnosis, distinguishing it from conditions like hemorrhoids.
Treatment strategies include medical management and surgical options like fissurectomy or lateral internal sphincterotomy.
Surgical technique preferences vary geographically, with lateral internal sphincterotomy often considered the gold standard in North America and the UK.