Management of acute anal fissure with open and closed internal sphincterotomy

https://doi.org/10.53730/ijhs.v6nS4.5661

Authors

  • Bhavin Shah Professor, Department of surgery, Smt. B.K Shah Medical Institute and Research Centre, Sumandeep Vidyapeeth deemed to be university (an institution)
  • Utkarsh Sharma Resident, Department of surgery, Smt. B.K Shah Medical Institute and Research Centre, Sumandeep Vidyapeeth deemed to be university (an institution)
  • Rutubahen Patel Resident, Department of surgery, Smt. B.K Shah Medical Institute and Research Centre, Sumandeep Vidyapeeth deemed to be university (an institution)
  • Honeypalsinh H Maharaul Associate professor, Department of surgery, Smt. B.K Shah Medical Institute and Research Centre, Sumandeep Vidyapeeth deemed to be university (an institution)

Keywords:

sphincterotomy, incontinence, constipation, anal fissure, perianal pain

Abstract

Introduction: An anal fissure is a lacerate tear in inner thin lining of anus. The tear exposes the muscle (anal sphincter) around the anus. The damage leads to muscle spasm, which pull the fissure edges even more. The spasms lead to pain and it also slow down the healing. An anal fissure is considered acute anal fissure if it occurs in less than 6 weeks or if it recently happened. Treatment done by breaking the cycle of spasm, relieving pain, and to avoid ischemia, which all are cause for anal fissure. First-line of treatment to minimize anal trauma includes stool softeners, bulk agents, and warm sitz baths(5) if not relived then sphincterotomy open or closed type surgery can be done. Material & Methods: We had conducted a comparative observational study from May 2019 to April 2021 at Dhiraj General Hospital, Vadodara in General Surgery department. In admitted patients posted for Sphincterotomy after consent & explaining risk factor, patients were operated. Detailed clinical history, clinical examination including per abdominal and per rectal examination, routine blood investigations & chest x-ray screening was done. In all the patients undergoing Sphincterotomy done either with open or closed method.

Downloads

Download data is not yet available.

References

Kodner IJ, Fry RD, Fleshman JW, Birnbaum EH, Read TE. Colon, Rectum and Anus. In: Schwartz Seymour I, et al. Principles of Surgery.1999;7:1265-1382.

Charles Orsay, Jan Rakinic, Brian Perry W, et al. Practice Parameters for the Management of Anal Fissures (Revised). Dis Colon rectum 2004;47:2003-7.

De Nardi PD, Ortolano E, Radaelli G, Staudacher C. Comparison of glycerine trinitrate and botulinum toxin-A for the treatment of chronic anal fissure: long term results. Dis Colon Rectum 2006;49(4):427–32.

Michael E, Friscia MD and Robert D. Anal pain: office diagnosis and treatment 2008;48:1-3.

Bullard KM, Rothenberger DA. Colon, Rectum and Anus. Shwartz’s Principles of Surgery 2005;8:28-1104.

McNamara MJ, Percy JP, Fielding IR. A manometric study of anal fissure treated by subcutaneous lateral internal sphincterotomy. Ann Surg 1990;211(2):235–238.

Eisenhammer S. The evaluation of the internal anal sphincterotomy operation with special reference to anal fissure. Surg Gynecol Obstet, 1959;109:583.

Gupta V, Rodrigues G, Prabhu R, Ravi C. Open versus closed lateral internal anal sphincterotomy in the management of chronic anal fissures: A prospective randomized study. Asian J Surg 2014;37(4):178–83.

Sanniyasi S, Alexander N, Thiyagarajan M. Open Versus Closed Lateral Internal Sphincterotomy in Chronic Anal Fissures: A Prospective Study. 2016; 4(7) ;124-6.

Mukri HM, Kapur N, Guglani V. Comparison of Open Versus Closed Lateral Internal Sphincterotomy in the Management of Chronic Anal Fissure. Hell J Surg 2019;91(2):91–5.

Published

08-04-2022

How to Cite

Shah, B., Sharma, U. ., Patel, R., & Maharaul, H. H. (2022). Management of acute anal fissure with open and closed internal sphincterotomy. International Journal of Health Sciences, 6(S4), 726–733. https://doi.org/10.53730/ijhs.v6nS4.5661

Issue

Section

Peer Review Articles