RT Book, Section
A1 Dooley-Hash, Suzanne
A1 Herrman, Nicholas W.C.
A2 Knoop, Kevin J.
A2 Stack, Lawrence B.
A2 Storrow, Alan B.
A2 Thurman, R. Jason
SR Print(0)
ID 1181041452
T1 Anal Fissure
T2 The Atlas of Emergency Medicine, 5e
YR 2021
FD 2021
PB McGraw-Hill
PP New York, NY
SN 9781260134940
LK accessmedicine.mhmedical.com/content.aspx?aid=1181041452
RD 2024/04/25
AB An  anal  fissure  is  a  longitudinal  tear  of  the  skin  of  the  anal  canal  that  extends  from  the  dentate  line  to  the  anal  verge.  It  is  the  most  common  cause  of  painful  rectal  bleeding.  Fissures  are  thought  to  be  caused  by  the  passage  of  hard  or  large  stools  with  constipation,  but  may  also  be  seen  with  diarrhea.  Incidence  follows  a  bimodal  distribution  with  fissures  most  commonly  seen  in  infants  and  middle-aged  adults.  Patients  present  with  intense  sharp,  burning  pain  during  and  after  bowel  movements.  Pain  may  be  accompanied  by  bright  red  blood.  Gentle  examination  with  separation  of  the  buttocks  usually  provides  adequate  visualization.  Anal  fissures  are  typically  a  few  millimeters  wide  and  most  commonly  occur  in  the  posterior  midline  where  the  skeletal  muscle  fibers  encircling  the  anus  are  weakest.