Anal fissure occurs predominantly in young adults but it is sometimes seen in infants and children. It is a longitudinal ulcer in the skin-lined part of the anal canal which probably starts as a simple tear. The edges become undermined and the base deepens to expose the circular fibres of the internal sphincter (Fig. 5.2). An anal papilla may develop at the level of the dentate line and a redundant skin tag at the distal end of the fissure (sentinel pile). Fissure is associated with a low fistula-in-ano or intersphincteric abscess in 5%–10% of cases and is the commonest anal lesion associated with Crohn’s disease.
KeywordsAnal Fissure Anal Fistula Internal Opening Pilonidal Sinus Hidradenitis Suppurativa
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