PRESENTED BY : ERICK AKWAN

Defined as longitudinal tear in the mucosa and skin of the anal canal. Commonly posterior midline more common in female than male. Lateral fissures are so rare there presence suggest specific lesions such as, Crohns disease, UC, TB or malignancy.
2

Aetiology

may be due to:

Tearing of the anal lining by over distension of the anal canal during passage of large scybalous mass (stool). Tearing of anal valve or fibrous polyps.
Laceration of the anal canal by sharp FB.

Excessive straining during child birth.

The acute anal fissure if not treated becomes chronic anal fissures. As result secondary pathological changes may occurs:

Chronicity A sentinel pile Hypertrophied anal papilla Contracture of the anus Suppuration

Usually affect, young or middle aged adult, common in female than male. Rare in old age may occur in infancy and may cause acquired mega colon.

Pain during and after defecation. Constipation Bleeding Discharge

 Fissure or ulcer distal to

dentate line.

Sentinel Tag Hypertrophied papilla. Spasms of the internal

sphincter