eMedicine Specialties > Pediatrics: Surgery > General Surgery
Anal Fissure: Workup
Updated: Mar 2, 2010
Workup
Laboratory Studies
- Laboratory and imaging studies are not routinely necessary in the workup of an anal fissure. However, if the clinician suspects the presence of an underlying disease process, additional tests are indicated, such as serology, purified protein derivative of tuberculin (PPD), stool cultures, biopsy, or further GI workup.
Imaging Studies
- An abdominal flat radiograph to check for constipation is often illustrative and serves as a baseline examination before beginning stool softeners.
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Workup: Anal Fissure |
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References
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Demirbag S, Tander B, Atabek C, et al. Long-term results of topical glyceryl trinitrate ointment in children with anal fissure. Ann Trop Paediatr. Jun 2005;25(2):135-7. [Medline].
Agnarsson U, Warde C, McCarthy G, Evans N. Perianal appearances associated with constipation. Arch Dis Child. Nov 1990;65(11):1231-4. [Medline].
Burd RS, Price MR. Evaluation and initial management of miscellaneous pediatric surgical problems. Pediatr Ann. 2001;30(12):752-9. [Medline].
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Garcia-Granero E, Sanahuja A, Garcia-Armengol J, et al. Anal endosonographic evaluation after closed lateral subcutaneous sphincterotomy. Dis Colon Rectum. May 1998;41(5):598-601. [Medline].
Jonas M, Neal KR, Abercrombie JF, Scholefield JH. A randomized trial of oral vs. topical diltiazem for chronic anal fissures. Dis Colon Rectum. Aug 2001;44(8):1074-8. [Medline].
Klosterhalfen B, Vogel P, Rixen H, Mittermayer C. Topography of the inferior rectal artery: a possible cause of chronic, primary anal fissure. Dis Colon Rectum. Jan 1989;32(1):43-52. [Medline].
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Motson RW, Clifton MA. Pathogenesis and treatment of anal fissure. In: Henry MM, Swash M, eds. Coloproctology and the Pelvic Floor. Butterworth-Heinemann; 1985:340-9.
Parellada C. Randomized, prospective trial comparing 0.2 percent isosorbide dinitrate ointment with sphincterotomy in treatment of chronic anal fissure: a two-year follow-up. Dis Colon Rectum. Apr 2004;47(4):437-43. [Medline].
Pena A. Surgical conditions of the anus, rectum, and colon. In: Behrman RE, Kliegman RM, Jenson HB, eds. Nelson Textbook of Pediatrics. Philadelphia, PA: WB Saunders Co; 2000:1181-3.
Shafik A. A new concept of the anatomy of the anal sphincter mechanism and the physiology of defecation. XV. Chronic anal fissure: a new theory of pathogenesis. Am J Surg. Aug 1982;144(2):262-8. [Medline].
Sonmez K, Demirogullari B, Ekingen G, et al. Randomized, placebo-controlled treatment of anal fissure by lidocaine,EMLA, and GTN in children. J Pediatr Surg. Sep 2002;37(9):1313-6. [Medline].
Stafford PW. Anal fissure. In: O'Neill JA, Rowe MI, Grosfeld JL, et al, eds. Pediatric Surgery. Elsevier Health Sciences; 1998:1454-5.
Tander B, Guven A, Demirbag S, et al. A prospective, randomized, double-blind, placebo-controlled trial of glyceryl-trinitrate ointment in the treatment of children with anal fissure. J Pediatr Surg. Dec 1999;34(12):1810-2. [Medline].
Further Reading
Keywords
anal fissure, fissure in ano, anal tear, tear of the squamous epithelial mucosa of the anal canal, tear of the anal canal, bright rectal bleeding, posterior midline tear, constipation, anorectal pain, passage of hard stool, blood in the stool, anorectal blood, rectal blood, rectal bleeding, anal skin tag, chronic ulcer, acquired immunodeficiency syndrome, chlamydia, gonorrhea, syphilis, neoplasm, sexual abuse, inflammatory bowel disease
Workup: Anal Fissure