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Photograph of anal fissure

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  • 11.05.2019
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Anorectal complaints in the emergency department ED can be associated with great stress or embarrassment for the patient, and often lead to delayed presentation, with patients attempting to self-treat or simply dealing with the symptoms. While most anorectal conditions are not life-threatening, they may cause significant discomfort. Patients may make an incorrect self-diagnosis of hemorrhoids. Likewise, the physician may also quickly attribute their symptoms to hemorrhoids. A recent study found suboptimal diagnostic accuracy for seven common anal pathologic conditions including prolapsed internal hemorrhoids, thrombosed external hemorrhoid, abscess, fissure, fistula, condyloma acuminata, and rectal prolapse that varied across specialties. Physicians correctly identified condylomata and rectal prolapse most frequently, and hemorrhoidal conditions least frequently.
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Clinical pictures: Perianal problems

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Anal Fissure • Picture • undeadstatesofamerica.com

This year-old man presented with a very painful infection. There was a large abscess which was easily palpable with surrounding cellulitis. It clearly needed incision so he was admitted for this to be done under general anaesthetic. There was no obvious underlying cause, such as inflammatory bowel disease or diabetes.
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Anal Fissure

Anal fissure fissure-in-ano is a very common anorectal condition. The exact etiology of this condition is debated; however, there is a clear association with elevated internal anal sphincter pressures. Though hard bowel movements are implicated in fissure etiology, they are not universally present in patients with anal fissures.
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photograph of anal fissure

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