Posterior anus diseases

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The American Journal of Surgery. Gough M J, Lewis A. Patients with posterior midline anal fissures have increased anal resting pressure, which causes hypertonia and thus delayed healing related to the decrease in blood perfusion pressure to the lining of the anus. An external or internal mass may be palpable. Simple cutaneous advancement flap anoplasty for resistant chronic anal fissure:

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J Am Coll Surg.

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Managing anal fissures

Cochrane Database Syst Rev. An external or internal mass may be palpable. There have been various studies on dosing and location of injection of the botulinum toxin, but the most common location is directly into the internal anal sphincter on either side of midline. Various studies have suggested that both anorectal mechanics and blood flow to the anal canal may play a role in anal fissure development. Optimal nonsurgical treatment of hemorrhoids: When conservative measures fail, a surgical approach becomes necessary for the definitive management of the chronic anal fissure.

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