Anal Fissure | Types, Causes, Differential Diagnosis and Management | V-Learning™ скачать в хорошем качестве

Anal Fissure | Types, Causes, Differential Diagnosis and Management | V-Learning™

👉 The general surgery Lecture at sqadia.com offers an in-depth Analysis of anal fissures, aimed at educating medical students on the essential aspects of this condition. This comprehensive lecture covers various aspects of anal fissures, including types, causes, differential diagnosis, and management approaches. ▬ 📃 Anal Fissure ▬▬▬▬▬▬▬▬▬▬ An anal fissure is a small tear in the lining of the lower rectum, causing pain and discomfort during bowel movements. It is classified into two types: 👉 Acute Anal Fissure Caused by trauma, such as passing a large or hard stool. 👉 Chronic Anal Fissure Results from repeated trauma, anal hypertonicity (increased muscle tone), or vascular insufficiency. ▬ 📜 Anal Fissure Causes ▬▬▬▬▬▬▬▬▬▬ Anal fissures can be caused by a variety of factors, which can lead to trauma or increased pressure on the anal canal. Some of the common causes include: ⚠️ Constipation Constipation is one of the most common causes of anal fissures. Passing large or hard stools during a bowel movement can cause excessive stretching and tearing of the anal mucosa. Chronic constipation increases the risk of developing an anal fissure over time. ⚠️ Diarrhea Frequent, forceful bowel movements can also lead to fissures due to irritation and inflammation of the anal mucosa. ⚠️ Childbirth Women can develop anal fissures as a result of the strain and pressure exerted on the anal area during childbirth. The risk increases with prolonged labor or the delivery of a large baby. ⚠️ Anal intercourse Engaging in anal intercourse without proper lubrication can cause trauma to the anal mucosa, resulting in an anal fissure. Adequate lubrication and gentle techniques can help reduce the risk. ⚠️ Crohn's disease Inflammatory bowel diseases, such as Crohn's, can cause anal fissures due to inflammation and irritation of the anal area. ⚠️ Overly tight or spastic anal sphincter muscles Increased pressure and tension in the anal sphincter can contribute to the development of fissures. ⚠️ Aging As people age, the skin and tissues around the anus may become less elastic and more prone to tearing. This can increase the risk of developing an anal fissure in older adults. ⚠️ Previous anal surgery A history of surgery in the anal area can lead to scarring and an increased risk of fissures. ▬ 📃 Clinical Features The primary symptom of anal fissure is pain during bowel movements. Patients may also experience bleeding, itching, or a burning sensation in the anal area. Chronic anal fissures can lead to the formation of a sentinel pile (skin tag) at the fissure's outer edge. ▬ 📜 Differential Diagnosis ▬▬▬▬▬▬▬▬▬▬ Anal fissures can be mistaken for several other conditions, such as hemorrhoids, anal abscesses, and inflammatory bowel disease (including Crohn's disease). A thorough examination and relevant tests are necessary for accurate diagnosis. ▬ 📃 Conservative Treatment ▬▬▬▬▬▬▬▬▬▬ Initial treatment for anal fissures includes conservative measures to promote healing and alleviate pain. These may include: Increasing fiber and water intake Stool softeners or laxatives Warm sitz baths Topical anesthetics, such as lidocaine Topical nitroglycerin or calcium channel blockers to relax the anal sphincter and promote blood flow. ▬ 📜 Operative Treatment ▬▬▬▬▬▬▬▬▬▬ If conservative treatments fail, surgical interventions may be considered: 👉 Lateral Anal Sphincterotomy A surgical procedure involving a small incision in the internal anal sphincter to relieve pressure and promote healing. There are two techniques: 👉 Open Technique The incision is left open to heal by secondary intention. 👉 Closed Technique The incision is closed using sutures. 👉 Anal Advancement Flap A procedure that involves mobilizing healthy tissue adjacent to the fissure to cover the defect, promoting healing. ▬ 📃 Complications of Surgery ▬▬▬▬▬▬▬▬▬▬ Surgical interventions, particularly lateral anal sphincterotomy, can lead to complications such as: 🩸 Hemorrhage Excessive bleeding during or after surgery. 👉 Fistula Abnormal connections between the anal canal and surrounding tissues. 👉 Hematoma A collection of blood outside the blood vessels, often requiring additional intervention. ▬ 🎬 5500+ sqadia.com Medical Videos ▬▬▬▬▬▬▬▬▬▬ 👩🏻‍⚕️ Medical students online education 24/7/365. 💡 Medical learning made easy. 💪 Study Hard, Dream Big. #GastrointestinalSurgery #Gastrology #Gastrointestinal #Surgicalprocedure #MedicalEducation #VLearning #HealthcareProfessionals #MedicalStudents #OnlineLectures #MedicalLecture #MedicalLectures