Management of acute anal fissure with open and closed internal sphincterotomy

Abstract

Introduction: An anal fissure is a lacerate tear in inner thin lining of anus. The tear exposes the muscle (anal sphincter) around the anus. The damage leads to muscle spasm, which pull the fissure edges even more. The spasms lead to pain and it also slow down the healing. An anal fissure is considered acute anal fissure if it occurs in less than 6 weeks or if it recently happened. Treatment done by breaking the cycle of spasm, relieving pain, and to avoid ischemia, which all are cause for anal fissure. First-line of treatment to minimize anal trauma includes stool softeners, bulk agents, and warm sitz baths(5) if not relived then sphincterotomy open or closed type surgery can be done. Material & Methods: We had conducted a comparative observational study from May 2019 to April 2021 at Dhiraj General Hospital, Vadodara in General Surgery department. In admitted patients posted for Sphincterotomy after consent & explaining risk factor, patients were operated. Detailed clinical history, clinical examination including per abdominal and per rectal examination, routine blood investigations & chest x-ray screening was done. In all the patients undergoing Sphincterotomy done either with open or closed method.