Pediatric Surgery for Anal Fissure Differential Diagnoses

Updated: Apr 29, 2020
  • Author: Brian P Gillett, MD; Chief Editor: Philip Glick, MD, MBA  more...
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DDx

Diagnostic Considerations

The differential diagnosis includes the following:

Also, sexual abuse should always be considered in the differential when patients with anal or genital complaints are evaluated.

Most anal fissures are single in number and occur at the posterior midline. Multiple fissures of the anal canal, lateral fissures, or those that extend proximal to the dentate line should raise the suspicion of a more serious underlying disease process. Lateral fissures should raise the possibility of trauma, infection, neoplasm, AIDS, syphilis, tuberculosis, or IBD.