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Analfissur

Sist revidert:
Sist revidert av:

Definisjon:
Analfissur er en sprekkdannelse i huden i analåpningen
Forekomst:
Vanlig tilstand
Symptomer:
Er en smertefull tilstand som kan gi spastisk krampe i endetarmen
Funn:
Fissuren ses ved inspeksjon av anus, i 90% av tilfellene tilsvarende kl. 6
Diagnostikk:
Vanligvis ikke påkrevd
Behandling:
Konservativ eller kirurgisk behandling der målet er å redusere hviletrykket og ev. spasmen i den interne analsfinkteren
  1. Stewart DB Sr, Gaertner W, Glasgow S, et al. Clinical practice guideline for the management of anal fissures. Dis Colon Rectum 2017; 60:7. PubMed  
  2. Cohee MW, Hurff A, Gazewood JD. Benign Anorectal Conditions: Evaluation and Management. Am Fam Physician. 2020;101(1):24-33. PMID: 31894930 PubMed  
  3. Zaghiyan KN, Fleshner P. Anal fissure. Clin Colon Rectal Surg 2011; 24:22. PubMed  
  4. Madalinski MH. Identifying the best therapy for chronic anal fissure. World J Gastrointest Pharmacol Ther 2011; 2:9. PubMed  
  5. Cross KL, Massey EJ, Fowler AL, et al; ACPGBI. The management of anal fissure: ACPGBI position statement. Colorectal Dis. 2008;10(suppl 3):1-7.
  6. Altomare DF, Binda GA, Canuti S, et al. The management of patients with primary chronic anal fissure: a position paper. Tech Coloproctol. 2011;15:135-141. PubMed  
  7. Nelson RL, Thomas K, Morgan J, Jones A. Non surgical therapy for anal fissure. Cochrane Database of Systematic Reviews 2012, Issue 2. Art. No.: CD003431. DOI: 10.1002/14651858.CD003431.pub3. DOI  
  8. Tejirian T, Abbas MA. Sitz bath: Where is the evidence? Scientific basis of a common practice. Dis Colon Rectum 2005; 48: 2336-40. PubMed  
  9. Samim M, Twigt B, Stoker L, Pronk A. Topical diltiazem cream versus botulinum toxin a for the treatment of chronic anal fissure: a double-blind randomized clinical trial. Ann Surg. 2012 Jan. 255 (1):18-22.
  10. Nelson RL, Manuel D, Gumienny C, et al. A systematic review and meta-analysis of the treatment of anal fissure. Tech Coloproctol. 2017;21(8):605–625. PMID: 28795245 PubMed  
  11. Gandomkar H, Zeinoddini A, Heidari R, et al. Partial lateral internal sphincterotomy versus combined botulinum toxin A injection and topical diltiazem in the treatment of chronic anal fissure: a randomized clinical trial. Dis Colon Rectum. 2015;58(2):228–234. PMID: 25585082 PubMed  
  12. Shao WJ, Li GC, Zhang ZK. Systematic review and meta-analysis of randomized controlled trials comparing botulinum toxin injection with lateral internal sphincterotomy for chronic anal fissure. Int J Colorectal Dis. 2009 Sep. 24 (9):995-1000.
  13. Brisinda G, Cadeddu F, Brandara F, Marniga G, Maria G. Randomized clinical trial comparing botulinum toxin injections with 0.2 per cent nitroglycerin ointment for chronic anal fissure. Br J Surg 2007; 94: 162-7. PubMed  
  14. Nelson RL, Chattopadhyay A, Brooks W, et al. Operative procedures for fissure in ano. Cochrane Database Syst Rev. 2011;(11):CD002199. The Cochrane Library  
  15. Liang J, Church JM. Lateral internal sphincterotomy for surgically recurrent chronic anal fissure. Am J Surg. 2015;210(4):715–719.
  16. Gupta V, Rodrigues G, Prabhu R, et al. Open versus closed lateral internal anal sphincterotomy in the management of chronic anal fissures: a prospective randomized study. Asian J Surg. 2014;37(4):178–183.
  17. Poritz LS. Anal fissure treatment & management. Medscape, last updated Dec 15, 2017.
  18. Fargo MV, Latimer KM. Evaluation and management of common anorectal conditions. Am Fam Physician 2012; 85: 624-30. American Family Physician  
  • Terje Johannessen, professor i allmennmedisin, Trondheim

Tidligere fagmedarbeidere

  • Hermod Petersen, professor og overlege, Norges teknisk-naturvitenskapelige universitet og Medisinsk avdeling, Regionsykehuset i Trondheim
  • Jon Erik Grønbech, professor og overlege, Norges teknisk-naturvitenskapelige universitet og Kirurgisk avdeling, Regionsykehuset i Trondheim