Anal Fissure...
Q How is Fissure diagnosed?
Diagnosis
can be made by inspection. Closer inspection will frequently reveal a tag or
sentinel pile. After gentle separation of the skin of the anal verge, the ulcer
usually posterior can be seen. Frequently the fibers of the internal anal
sphincter muscle can be seen at the base of this punched-out ulcer. A
well-lubricated finger with lidocaine ointment and a small caliber anoscope
will help delineate the extent of the lesion. A colonoscope or sigmoidoscope
exam might be useful to rule out abscesses, colitis, and other causes of rectal
bleeding.A
fissure should be distinguished from an ulcer caused by Crohn's disease,
leukemia, or malignant tumors, because it is not shaggy,
large or indolent. Fissures are seldom multiple. A biopsy
can help to determine the diagnosis
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