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Benign Anal Disease: When to Operate on the Patient with an Anal Fissure

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Difficult Decisions in Colorectal Surgery

Part of the book series: Difficult Decisions in Surgery: An Evidence-Based Approach ((DDSURGERY))

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Abstract

Anal fissures have been reported to affect an estimated 235,000 individuals per year, though the true incidence is likely higher. The majority of anal fissures are associated with high internal anal sphincter tone. The etiology is thought to be related to local trauma caused by hard stool and/or related to chronic ischemia associated with increased sphincter pressures. While most acute fissures heal spontaneously with stool bulking, local care, and topical treatments, the management of chronic fissures, specifically the decision on when lateral internal sphincterotomy (LIS) is appropriate, represents a clinical challenge.

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Authors and Affiliations

  1. Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    David J. Berler MD

  2. Division of Colon and Rectal Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA

    Randolph M. Steinhagen MD

Authors
  1. David J. Berler MD
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  2. Randolph M. Steinhagen MD
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Correspondence to Randolph M. Steinhagen MD .

Editor information

Editors and Affiliations

  1. Medical Center, University of Chicago, Chicago, Illinois, USA

    Neil Hyman

  2. Medical Center, University of Chicago, Chicago, Illinois, USA

    Konstantin Umanskiy

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Berler, D.J., Steinhagen, R.M. (2017). Benign Anal Disease: When to Operate on the Patient with an Anal Fissure. In: Hyman, N., Umanskiy, K. (eds) Difficult Decisions in Colorectal Surgery. Difficult Decisions in Surgery: An Evidence-Based Approach. Springer, Cham. https://doi.org/10.1007/978-3-319-40223-9_34

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  • DOI: https://doi.org/10.1007/978-3-319-40223-9_34

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-40222-2

  • Online ISBN: 978-3-319-40223-9

  • eBook Packages: MedicineMedicine (R0)

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