5-Minute Emergency Consult
Anal Fissure
Anal Fissure is a topic covered in the 5-Minute Emergency Consult.
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Basics
Description
Description
- Hard stool passes and “cuts” anoderm
- Linear tear extends from dentate line to anoderm:
- Posterior midline 95%
- Anterior midline 5%
- Externally: Forms skin tag or sentinel pile
- Internally: Forms hypertrophied anal papilla
- Chronic fissure may reveal an ulcer with fibers of internal sphincter with sentinel pile
Etiology
Etiology
- Stress or an overly tight anal sphincter leads to local ischemia of posterior anoderm
- Diarrhea or hard bowel movement tears anoderm
- Local trauma from anal intercourse or sexual abuse may be the cause
- Lateral fissures indicate underlying causative systemic disease:
- Crohn disease
- Anal cancer
- Leukemia
- Syphilis
- Previous anal surgery
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Basics
Description
Description
- Hard stool passes and “cuts” anoderm
- Linear tear extends from dentate line to anoderm:
- Posterior midline 95%
- Anterior midline 5%
- Externally: Forms skin tag or sentinel pile
- Internally: Forms hypertrophied anal papilla
- Chronic fissure may reveal an ulcer with fibers of internal sphincter with sentinel pile
Etiology
Etiology
- Stress or an overly tight anal sphincter leads to local ischemia of posterior anoderm
- Diarrhea or hard bowel movement tears anoderm
- Local trauma from anal intercourse or sexual abuse may be the cause
- Lateral fissures indicate underlying causative systemic disease:
- Crohn disease
- Anal cancer
- Leukemia
- Syphilis
- Previous anal surgery
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Citation
Schaider, Jeffrey J., et al., editors. "Anal Fissure." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307092/all/Anal_Fissure.
Anal Fissure. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307092/all/Anal_Fissure. Accessed March 30, 2023.
Anal Fissure. (2016). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (5th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307092/all/Anal_Fissure
Anal Fissure [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2023 March 30]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307092/all/Anal_Fissure.
* Article titles in AMA citation format should be in sentence-case
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ED - Wolfe,Richard E,
BT - 5-Minute Emergency Consult
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PB - Lippincott Williams & Wilkins
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