(Rawal Med J 2010 35: ).Ĭhronic anal fissure, sentinel skin tag, lateral internal sphincterotomy.Ĭhronic anal fissure is a linear tear in anal mucosa which persists for more than 6 weeks.1-3 It is an extremely painful condition with an incidence of about 10% in general surgical practice.1 It causes significant functional and psychosocial impairment.4 Several treatment options are available and lateral internal sphincterotomy (LIS) was considered as “gold standard” until the successful use of topical agents including nitric oxide donors, calcium channel blockers and botulinum toxin. There was significant association of skin tags with fissures undergoing LIS (p < 0.001).Īssociation with a sentinel skin tag is a predictor of failure of medical treatment for chronic anal fissure. 39(21.7%) patients had associated skin tag, 23(12.8%) had hemorrhoids and 12(6.7%) had multiple fissures. ![]() Out of 180 patients, 149(82.8%) healed with GTN ointment, 31(17.2%) underwent LIS. The frequency of multiplicity and any association with skin tags or hemorrhoids was noted in two groups using chi-square test for statistical analysis. Out of them, 31 patients underwent lateral internal sphincterotomy (LIS) due to non-healing or recurrence despite at least 6 weeks therapy of 0.2% Glyceryl trinitrate (GTN) ointment. This cross sectional comparative study was performed on 180 patients who presented with chronic anal fissure. To compare characteristics of the chronic fissures which healed with pharmacological agents with those which ultimately required sphincterotomy. ![]() Chronic anal fissures- association with sentinel skin tagĪfsheen Zafar, Ahmed Rehman, Mohammad Iqbal Khan.
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