Anal Fissure<\/p>\r\n\r\n\r\n\r\n
Anal fissure is described as a laceration or tear that occurs along the vertical axis of the squamous lining of the anal canal between the anal margin and the dentate line (Londo\u00f1o 2005).<\/p>\r\n\r\n\r\n\r\n
The vast majority of anal fissures occur in the posterior midline (Orsay 2004), affecting males and females equally. Anterior fissures are more frequent in women (up to 15%) but are rare in men (1%) (Metcalf 2002, Lund 1996). Anterior fissures can be associated with childbirth in 3 to 11% (Lund 1996).\u00a0<\/p>\r\n\r\n\r\n\r\n
The presence of multiple fissures or fissures that are located laterally raises suspicion of other diseases such as Crohn's disease, ulcerative colitis, tuberculosis, HIV, syphilis, or anal cancer. However, most fissures in patients with inflammatory bowel disease are located in the posterior midline and are painful in more than 50% of cases (Lund 1996).<\/p>\r\n\r\n\r\n\r\n
Fissures are classified as acute and chronic. The classification is based on the time of evolution and clinical appearance. Acute fissures are usually superficial, well demarcated, with fresh mucosal borders and granulation tissue at the base (Metcalf 2002), but may deepen and expose the underlying internal sphincter.<\/p>\r\n\r\n\r\n\r\n
Most heal spontaneously or by medical treatment with very general measures. A fissure can be classified as chronic when symptoms have lasted at least 6 weeks (Lindsey 2004, Metcalf 2002, Kocher 2002, McCallion 2001) and characteristic secondary changes have developed such as the presence of redundant sentinel skin, the development of a hypertrophic anal papilla, induration of the fissure border, exposure of the internal sphincter fibers, and even functional anal stenosis (due to sphincteric spasm) or anatomic anal stenosis due to fibrosis of the internal sphincter (Orsay 2004) (Metcalf 2004).\u00a0<\/p>\r\n\r\n\r\n\r\n
For Scholefield and colleagues (2003) for a fissure to be considered chronic there must be persistence of symptoms for at least 12 weeks and there must be the presence of at least two macroscopic features of chronicity (redundant sentinel skin, hypertrophic anal papilla, exposure of the internal sphincter, lateral fibrotic fissure, fibrotic anal sphincter) (Scholefield 2003).<\/p>","protected":false},"excerpt":{"rendered":"
Fisura Anal la fisura anal se describe como una laceraci\u00f3n o desgarro que ocurre a lo largo del eje vertical del recubrimiento escamoso del canal anal entre la margen anal y la l\u00ednea dentada (Londo\u00f1o 2005). La gran mayor\u00eda de las fisuras anales ocurren en la l\u00ednea media posterior (Orsay 2004), afectan por igual a […]<\/p>\n","protected":false},"author":1,"featured_media":7705,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"off","_et_pb_old_content":"","_et_gb_content_width":"","_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-1060","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/www.institutodecoloproctologia.com\/en\/wp-json\/wp\/v2\/posts\/1060","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.institutodecoloproctologia.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.institutodecoloproctologia.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.institutodecoloproctologia.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.institutodecoloproctologia.com\/en\/wp-json\/wp\/v2\/comments?post=1060"}],"version-history":[{"count":2,"href":"https:\/\/www.institutodecoloproctologia.com\/en\/wp-json\/wp\/v2\/posts\/1060\/revisions"}],"predecessor-version":[{"id":7262,"href":"https:\/\/www.institutodecoloproctologia.com\/en\/wp-json\/wp\/v2\/posts\/1060\/revisions\/7262"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.institutodecoloproctologia.com\/en\/wp-json\/wp\/v2\/media\/7705"}],"wp:attachment":[{"href":"https:\/\/www.institutodecoloproctologia.com\/en\/wp-json\/wp\/v2\/media?parent=1060"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.institutodecoloproctologia.com\/en\/wp-json\/wp\/v2\/categories?post=1060"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.institutodecoloproctologia.com\/en\/wp-json\/wp\/v2\/tags?post=1060"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}