Surgery » General Surgery » Anal & Perianal

Anal Fissure & Fistula

An anal fissure is a superficial linear tear in the anoderm most commonly caused by passage of a large, hard stool. This tear is distal to the dentate line. An anal fistula is an inflammatory tract between the anal canal and skin. The following 4 categories of fistulas exist, based on the relationship of fistula to sphincter muscles: intersphincteric, transsphincteric, suprasphincteric, and extrasphincteric. Most uncomplicated fissures resolve in 2-4 weeks with supportive care. Chronic anal fissures frequently require surgical treatment. All surgical procedures involve stretching or cutting internal sphincter. The most common surgical procedure is lateral internal sphincterotomy.

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