Anal Fissures

Excerpt

An anal fissure is a superficial tear in the skin distal to the dentate line and is a cause of frequent emergency department visits. In most cases, anal fissures are a result of hard stools or constipation, or injury. Anal fissures are common in both adults and children, and those with a history of constipation tend to have more frequent episodes of this condition. Anal fissures can be acute (lasting less than 6 weeks) or chronic (more than 6 weeks). The majority of anal fissures are considered primary and typically occur at the posterior midline. See Image. Chronic Posterior Anal Fissure. A small percentage of these may occur at the anterior midline. Other locations (atypical/secondary fissures) can be caused by other underlying conditions that require further workup. The diagnosis of an anal fissure is primarily clinical. Several treatment options exist, including medical management and surgical options.