Photograph of anal fissure

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Comparative study of Ksharasutra suturing and Lord's anal dilatation in the management of Parikartika chronic fissure-in-ano. Parikartika resembles fissure-in-ano which is very common among all ano -rectal disorders. In Ayurvedic texts, Parikartika is described as a complication of Vamana and Virechana as well as complication of Atisara.

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Biography: Jaya Maheshwari. Statement of the Problem: A chronic anal fissure can be identified by the presence of hypertrophied anal papilla, visible internal sphincter fibres at the base of the fissure, a sentinel polyp at the distal end or a fibroepithelial polyp at the apex. The ischemia of the anal lining caused due to elevated sphincter pressures, may be responsible for the pain of anal fissures and their failure to heal.

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An anal fissure is a tear in the lining of the lower rectum anal canal that causes pain during bowel movements. Anal fissures don't lead to more serious problems. Most anal fissures heal with home treatment after a few days or weeks.

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Anal fissures are tiny tears in the skin around the anus and can be painful. They usually develop as a side effect of constipation. Constipation is the condition where a person passes faeces poo less frequently than usual and the poo is harder, drier and painful to pass.

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A year-old, previously healthy woman presented with several weeks of painful defecation accompanied by a small amount of bleeding. Examination revealed an anal fissure in the anterior position. After several months of conservative treatment with sitz baths, stool softeners, and increased fluid intake, the fissure had not healed. She experienced more pain, bleeding with every bowel movement, and the formation of a nontender skin tag in the anterior position.

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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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We present the case of a year-old woman who attended a surgical outpatient clinic with symptoms of perianal fissure due to syphilitic infection. This uncommon aetiology of a common condition is often alluded to in textbooks, but little information exists in the scientific literature regarding the pathogenesis, presentation and treatment of fissure-in-ano secondary to syphilis. We present the case and an overview of the topic aimed at surgeons and clinicians who manage patients with perianal pathology.

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