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Primäre Analfissur

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Chirurgische Proktologie

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Zusammenfassung

Die Analfissur gehört zu den häufigsten proktologischen Erkrankungen. Es findet sich kein geschlechtsspezifischer Unterschied, auch kann jedes Alter betroffen sein, seltener allerdings Menschen im höheren Lebensalter. Typische Zeichen sind Schmerzen bei der Defäkation, häufig mit Blutauflagerungen am Stuhl sowie Pruritus im Analbereich. Die Schmerzen können so stark sein, dass eine digitale Untersuchung ohne Anästhesie gar nicht möglich ist. Bei der Inspektion zeigt sich eine strichförmige oder längs-ovale Ulzeration zwischen Linea dentata und Analrand. In aller Regel findet sie sich hinten bei 6 Uhr, kann jedoch auch mal vorn in der Mittellinie auftreten, dann allerdings überwiegend bei Frauen.

Die akute Analfissur kann spontan abheilen oder durch lokale Anwendung von Hydrokortison oder einem sphinkterdrucksenkendem Medikament (Botulinumtoxin, Nifedipin, Diltiazem). Heilt die Fissur unter diesen Maßnahmen nicht ab bzw. entwickelt sich eine chronische Fissur, dann ist die Indikation zur chirurgischen Therapie in Form der Exzision und Sphinkterotomie gegeben.

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© 2006 Springer Medizin Verlag Heidelberg

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(2006). Primäre Analfissur. In: Chirurgische Proktologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-29037-0_5

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  • DOI: https://doi.org/10.1007/3-540-29037-0_5

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-20030-7

  • Online ISBN: 978-3-540-29037-7

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