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Anal Fissure

Antonio Arroyo, Elisa Montes, Teresa Calderón, Isabel Blesa, Manuela Elía, Gervasio Salgado, Juan García-Armengol, Fernando de-la-Portilla
The Spanish Association of Coloproctology and the Coloproctology Division of the Spanish Association of Surgeons propose this consensus document with a treatment algorithm for anal fissure that could be used for decision making. Non-surgical therapy and surgical treatment of anal fissure are explained, and the recommended algorithm is provided. The methodology used was: creation of a group of experts; search in PubMed, MEDLINE and the Cochrane Library for publications from the last 10 years about anal fissure; presentation at the 21st National Meeting of the Spanish Association of Coloproctology Foundation 2017 with voting for/against each conclusion by the attendees and review by the scientific committee of the Spanish Association of Coloproctology...
March 8, 2018: Cirugía Española
David Parés, Herand Abcarian
Benign anorectal conditions produce anal pain, rectal bleeding, or discharge from the perianal region, which are highly prevalent symptoms in the general population. Hemorrhoidal disease, anal fissure, perianal abscess, proctalgia syndromes and pruritus anii are the most common clinical disorders. Well-trained physicians irrespective of their specialty can treat most of these disorders and refer them to a specialist in proctology only when necessary. The aim of this review is to provide a practical guide to the management of benign anorectal disorders in terms of their initial management and the criteria for specialist referral...
February 27, 2018: American Journal of Medicine
Shuo Chen, Zhiguang Huan, Lin Zhang, Jiang Chang
BACKGROUND: The object of the present study is to evaluate the feasibility of a silicate-based wound dressing (DermFactor® ) in treating the wound of the patients after anorectal surgery. MATERIALS AND METHODS: The present study included 328 patients who received anal surgery during the period from March 2013 to June 2015. The patients were randomized to 2 groups. The patients (n = 162) in the control group received conventional dressing therapy, while those in the observation group (n = 166) were treated with the combination of conventional dressing therapy and the use of a silicate-based wound dressing (DermFactor® )...
February 23, 2018: International Journal of Surgery
Luis Santiago, Ana Luísa Moura, Inês Coutinho, Margarida Gonçalo
Topical anesthetics for the treatment of anal fissures or hemorrhoids are a frequent cause of allergic contact dermatitis (ACD) in the perianal region1 . Since 2009, a few cases have been reported also to the calcium channel blocker diltiazem2,3,4 used as a first-line agent in the treatment of anal fissures. We present a case of ACD from diltiazem and/or cinchocaine followed by systemic contact dermatitis (SCD). This article is protected by copyright. All rights reserved.
February 8, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
Kim Champion Lu
No abstract text is available yet for this article.
March 2018: Diseases of the Colon and Rectum
Emily Steinhagen
No abstract text is available yet for this article.
March 2018: Diseases of the Colon and Rectum
Mina Alvandipour, Shahram Ala, Mehdi Khalvati, Jamshid Yazdanicharati, Neda Koulaeinejad
BACKGROUND: Anal fissure is a common anorectal problem causing severe pain and discomfort to the patients. Chemical sphincterotomy has emerged as a noninvasive alternative to the surgical methods of fissure treatment. The objective of this study was evaluation of the efficacy and the adverse effects of topically applied minoxidil in chemical sphincterotomy of chronic anal fissure in comparison with topical diltiazem. METHODS: A total of 88 patients with chronic anal fissure aged between 15 and 65 years were included in this double-blind, randomized clinical trial and were randomly assigned to either 0...
December 31, 2017: World Journal of Surgery
M Del Mar Aguilar, Pedro Moya, M José Alcaide, Alba Fernández, M Amparo Gómez, Jair Santos, Rafael Calpena, Antonio Arroyo
INTRODUCTION: The treatment of chronic anal fissure (FAC) differs depending on the professional. To come to a consensus, the current situation in Spain should be studied. The aim of this study is to evaluate the current situation of the management of FAC in Spanish hospitals. METHODS: Descriptive study, with data from a survey of surgeons of the Spanish Association of Coloproctology. Data was collected according to the doctor's autonomous community, type of hospital and professional category; FAC management data and 3 clinical cases...
December 12, 2017: Cirugía Española
Shaheel Mohammad Sahebally, Stewart Redmond Walsh, Waqas Mahmood, Thomas Michael Aherne, Myles Richard Joyce
BACKGROUND: Chronic anal fissures (CAF) are common and associated with reduced quality of life. Lateral internal sphincterotomy (LIS) is frequently carried out but carries a significant risk of anal incontinence. Anal advancement flap (AAF) has been advocated as an alternative, 'sphincter-preserving' procedure. We aimed to perform a systematic review and meta-analysis to compare the efficacy of both techniques in the treatment of CAF. METHODS: The online databases of PubMed/Medline, CINAHL, EMBASE and Cochrane Central Register of Controlled Trials were searched from inception to January 2017...
January 2018: International Journal of Surgery
Songhua Deng, Li Mo, Wenwen Deng, Sai Chen, Yongheng He
OBJECTIVE: To evaluate the difference in the clinical therapeutic effects on anal fissure at Ⅰ and Ⅱ stages between the acupoint catgut embedding therapy and western medication. METHODS: Sixty patients of anal fissure at Ⅰ and Ⅱ stages were randomized into an embedding therapy group and a western medication group, 30 cases in each one. In the embedding therapy group, the acupoint catgut embedding therapy was applied at bilateral Tianshu (ST 25), Changqiang (GV 1), bilateral Chengshan (BL 57) and Tigangxue (Extra), once a week...
April 12, 2017: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
Andrew J FitzDowse, Corina C Behrenbruch, Ian P Hayes
BACKGROUND: Anal fistula in association with chronic anal fissure (fissure-fistula) is infrequently described. Recognizing this association and managing both components may help prevent some treatment failures seen with chronic anal fissure. This study aims to report on the outcomes of 20 consecutive patients with fissure-fistula managed with fistulotomy and injection of botulinum A toxin. METHODS: The study is a retrospective, observational study, assessing the success of symptom resolution following fistulotomy with botulinum A toxin, in patients identified as having a chronic anal fissure with associated anal fistula...
December 3, 2017: ANZ Journal of Surgery
S M Sahebally, B Meshkat, S R Walsh, D Beddy
AIM: Chronic anal fissures (CAFs) are frequently encountered in coloproctology clinics. Chemical sphincterotomy with pharmacological agents is recommended as first-line therapy. Topical nitrates (TN) heal CAF effectively but recurrences are common. An alternative treatment modality is injection of botulinum toxin (BT) into the anal sphincter. We aimed to perform an updated systematic review and meta-analysis to compare the effectiveness of BT and TN in the management of CAF. METHOD: PubMed, EMBASE and Cochrane databases were searched for relevant articles from inception until March 2017...
January 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
A E Vasil'eva, N V Makashova, I A Ronzina, O Yu Kolosova, K V Goncharenko, Z A Alobeyd
The authors describe a case of severe glaucoma in the only seeing eye of a patient with venous circulation disturbance resulting from a chronic anal fissure complicated with progressive anal stenosis, severe sphincter spasm, and pain syndrome. The article presents the results of multiple clinical ophthalmological tests and instrumental examinations performed before and after surgical intervention that evidence the importance of venous circulation disturbances for glaucoma development.
2017: Vestnik Oftalmologii
A M Sarıışık, S Y Karavana, G C Türkoğlu, S Rençber, T Önder
Anal fissure is common and painful disease of anorectum. In this study, microparticles containing nifedipine and lidocaine HCl were prepared by spray drying and applied to bio-degradable and bio-stable tampons. Characterization of microparticles was determined by visual analyses, mass yield, particle size measurement, encapsulation efficiency, drug loading and in vitro drug release. Mass yield was between 5.5 and 45.9%. The particle size was between 15.1 and 26.8 µm. Encapsulation efficiency were 96.142 ± 5...
November 5, 2017: Journal of Microencapsulation
P Ravindran, D L Chan, C Ciampa, R George, G Punch, S I White
BACKGROUND: There is no consensus on the optimal dosage of botulinum toxin (BT) as a sphincter sparing alternative to lateral internal sphincterotomy for chronic anal fissure. The aim of this study was to assess the long-term efficacy of high-dose BT as well as the presence of incontinence following the treatment of chronic anal fissure at a single institution. METHODS: A retrospective case-control study was performed at a single institution over a 6-year period (2009-2014)...
October 2017: Techniques in Coloproctology
Nina Sonne Bundgaard, Kikke Kirsten Hagen, Andreas Nordholm-Carstensen
Anal fissure is a common ailment, however, the pathophysiology and optimal treatment strategy is unclear. Anal fissures may be classified as acute or chronic. Acute fissures are effectively treated and prevented with conservative measures, whereas chronic fissures typically require medical or surgical therapy. Invasive interventions have superior healing rates compared with local medical therapies, but may cause persistent incontinence. New interventions are constantly introduced and may be of value in patients with high risk of incontinence, but more evidence is currently needed...
October 23, 2017: Ugeskrift for Laeger
Fausto Fama', Maria Gioffrè-Florio
No abstract text is available yet for this article.
August 2017: Acta Medica Iranica
Roberta Granese, Gloria Calagna, Giuliana Morabito, Carmine Carriero, Antonio Perino, Gabriele Tonni, Claudio Romano
PURPOSE: The aim of the study is to report a systematic review (from 2000 to 2017) of all pediatric cases of vulvar Crohn's disease (VCD) and to highlight the key-points for a correct diagnosis and management of this rare condition. METHODS: An electronic search using the Pubmed/Medline, Scopus, EMBASE, Cochrane database and Google Scholar database was performed according to PRISMA guidelines. RESULTS: Twenty pediatric studies and 22 cases of VCD were included for analysis...
September 25, 2017: Archives of Gynecology and Obstetrics
Sundaramurthi Sudharsanan, Chellappa Vijayakumar, Kumar Manish, T P Elamurugan, Ali S Manwar
Gas gangrene is one of the most serious infections of traumatic and surgical wounds. The importance lies in the fact that, if not managed at the right time, the condition is fatal. Though perianal cellulitis and gangrene are commonly reported in immunocompromised patients, we report the case of a patient with gas gangrene involving only the anal canal extending to the rectum, a rare presentation to be reported in literature.  An 18-year-old lady, a patient of aplastic anaemia - immunodeficiency, developed gas gangrene of the anal canal possibly due to faecal contamination of anal fissures...
July 13, 2017: Curēus
H Turgut, R Ozdemir, I K Gokce, C Karakurt, A Karadag
Sirenomelia, also known as "mermaid malformation/syndrome," is a rare, serious congenital anomaly characterized by variable degrees of fusion of the lower limbs and associated with severe malformations of vertebral, genitourinary, cardiovascular system and single umbilical artery. The first pregnancy of a 25-year-old woman resulted in one twin born by Cesarian section at 32 weeks' gestation, who was referred to our hospital with cyanosis, a congenital anomaly and respiratory distress. On physical examination, there was no urogenital region and anal fissure and gender was indeterminate...
June 30, 2017: Balkan Journal of Medical Genetics: BJMG
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