Search results for "anal fissure"
showing 10 items of 25 documents
Diseases of the External Anal Area
1979
Diseases of the external anal area may be diagnosed during inspection using good lighting. Because of the variable responses to treatment, the individual diseases should be diagnostically distinguished from one another.
Anitis — Cryptitis — Papillitis
1979
Inflammatory processes within this transitional zone cannot be separated from one another and often occur together. The source of the infection will usually be found in the crypts of Morgagni, originating in the dorsal crypts and spreading to the adjacent papillae. The area of involvement appears erythematous and edematous, and pus occasionally exudes from the crypts. An association exists between cryptitis and the development of anal fissures, and between anal fissures and hemorrhoidal diseases. The anal canal is for the most part also involved in the inflammatory process. One encounters an anitis, which because of an increased secretion produces a perianitis and perpetuates a perianal ecz…
Botulinum Toxin Injection Plus Topical Diltiazem for Chronic Anal Fissure: A Randomized Double-Blind Clinical Trial and Long-term Outcome.
2021
BACKGROUND: Chemical sphincterotomy avoids the risk of permanent incontinence in the treatment of chronic anal fissure, but it does not reach the efficacy of surgery and recurrence is high. Drug combination has been proposed to overcome these drawbacks.; OBJECTIVE: This study aimed to compare the clinical, morphological, and functional effects of combined therapy with botulinum toxin injection and topical diltiazem in chronic anal fissure and to assess the long-term outcome after healing.; DESIGN: This is a randomized, controlled, double-blind, 2-arm, parallel-group trial with a long-term follow-up.; SETTINGS: This study was conducted at a tertiary care center.; PATIENTS: A total of 70 cons…
Internal sphincterotomy reduces postoperative pain after Milligan Morgan haemorrhoidectomy
2009
Abstract Background Over the last few years, there has been increasing attention on surgical procedures to treat haemorrhoids. The Milligan-Morgan haemorrhoidectomy is still one of the most popular surgical treatments of haemorrhoids. The aim of the present work is to assess postoperative pain, together with other early and late complications, after Milligan-Morgan haemorrhoidectomy as we could observe in our experience before and after performing an internal sphincterotomy. Methods from January 1980 to May 2007, we operated 850 patients, but only 699 patients (median age 53) were included in the present study because they satisfied our inclusion criteria. The patients were divided into two…
Lateral internal sphincterotomy is still crucial to heal hypertonic chronic anal fissure and normalize the internal anal sphincter tone? Is V-en Y pl…
2021
INTRODUCTION: The role of augmented internal anal sphincter (IAS) tone in the genesis of chronic anal fissure (CAF) is still unclear. Lateral internal sphincterotomy (LIS) is the most employed surgical procedure, aiming to reduce the IAS tone leaving a permanent anatomical alteration and it is burdened by high risk post-operative anal incontinence (AI). The aim of this work was to evaluate if the pre-operative manometric alterations of CAFs with hypertonic IAS would normalize after sphincter preserving surgical procedure. METHODS: We enrolled 108 consecutive patients affected by idiopathic and non-recurrent CAF undergone fissurectomy and anoplasty with V-Y cutaneous flap advancement and pha…
Therapeutic effects of different doses of botulinum toxin in chronic anal fissure
1999
PURPOSE: The aim of this study was to evaluate the clinical and manometric results of three different doses of botulinum toxin and two methods of injection for the treatment of chronic idiopathic anal fissure. METHODS: Sixty-nine patients with chronic anal fissure were included in a nonrandomized, prospective trial of intrasphincteric injection of botulinum toxin. All patients reported postdefecatory anal pain lasting more than two months. Scoring systems were developed for anal pain, bleeding, and defecatory difficulty. Maximum resting and squeeze anal pressures were determined before and one month after treatment. Twenty-three patients undergoing a 5-U injection of diluted botulinum toxin…
Tratamientos terapéutica de la fisura anal crónica
2005
Current treatment of chronic anal fissure continues to be based on conventional conservative measures in a high percentage of cases. What is known as chemical sphincterotomy aims to achieve a temporary decrease of anal pressures that allows fissures to heal. There are various alternatives such as nitroglycerine or diltiazem ointment and botulinum toxin injections. However, because of collateral effects and recurrences in the medium term, the definitive role of these treatments remains to be elucidated. Nevertheless, chemical sphincterotomy should be the first option in patients with a high risk of incontinence. "Open" or "closed" lateral internal sphincterotomy performed in the ambulatory s…
Digital Rectal Examination (Fig. 2a and 2b)
1979
During examination of the anal region and before doing the rectal examination, the hand is protected by a plastic glove. A number of disposable gloves of varying strengths are on the market. One may additionally use a finger cot on the forefinger, which is removed after the examination. The examination can also be done using a finger cot alone with the finger stuck through a piece of gauze that protects the rest of the hand. Right-handed examiners often elect to use the forefinger of the left hand for the rectal examination and keep the right hand uncontaminated for handling instruments.
Fisurectomy and anoplasty with botulinum toxin injection in patients with chronic anal posterior fissure with hypertonia: a long-term evaluation.
2020
AbstractChronic anal fissure’s (CAF) etiopathogenesis remain unclear. CAF of the posterior commissure (CAPF) are often characterized by internal anal sphincter (IAS) hypertonia. The treatment of this disease aimed to reduce IAS hypertonia. Due to the high rate of anal incontinence after LIS, the employment of sphincter preserving surgical techniques associated to pharmacological sphincterotomy appears more sensible. The aim of our study is to evaluate the long-term results of fissurectomy and anoplasty with V–Y cutaneous flap advancement associated to 30 UI of botulinum toxin injection for CAPF with IAS hypertonia. We enrolled 45 patients undergone to fissurectomy and anoplasty with V–Y cut…
Surgical sphincter saving approach and topical nifedipine for chronic anal fissure with hypertonic internal anal sphincter
2020
PURPOSE The role of augmented internal anal sphincter (IAS) tone in the genesis of posterior chronic anal fissure (CAPF) is still unknown. Lateral internal sphincterotomy is the most employed surgical procedure, nevertheless it is burdened by high risk post-operative anal incontinence. The aim of our study is to evaluate results of sphincter saving procedure with post-operative pharmacological sphincterotomy for patients affected by CAPF with IAS hypertonia. Methods: We enrolled 30 patients, undergone fissurectomy and anoplasty with V-Y cutaneous flap advancement; all patients received topical administration of nifedipine 0.3% and lidocaine 1.5% ointment-based therapy before and for 15 days…