Utility of Ultrasound in the Evaluation of Chronic Anal Fissure

Author Info

Ashraf Talaat Youssef

Corresponding Author

Ashraf Talaat Youssef
Department of Radiology, Faculty of Medicine, Fayoum University, Egypt

A B S T R A C T

Introduction: Anal fissure is a linear tear in the anal mucosa seen distal to the dentate line. The diagnosis of chronic anal fissure depends on clinical history, physical exam, anoscopy and other imaging modalities are uncommonly recommended unless an associated condition was suspected. Management is either by chemical sphincterotomy or surgery through lateral internal sphincterotomy when chronic anal fissure was resistant to treatment. Purpose of the Study: The current study aimed to evaluate the sonographic findings that can be observed in cases with chronic anal fissure and their significance. Methodology: 15 asymptomatic patients and 30 patients with chronic anal fissure were examined with 3 dimensional transperineal ultrasound and if females an additional transvaginal ultrasound was performed. Results: 26 patients (86.5%) showed diffusely thickened internal anal sphincter of mean thickness >3.5mm, ranging from 3.7 mm to 6.4mm and the mean value was 5mm. 3 patients (10%) with posterior fissure showed a lucent narrow defect in the internal anal sphincter at the midline of the distal aspect of the anal canal wall. One of them showed associated localized intersphincteric plane sepsis. Conclusion: Use of ultrasound in cases with chronic anal fissure may show gapping of the internal anal sphincter and an associated intersphincteric plane sepsis corresponding to the high morphological grade of anal fissure which predict poor healing response to chemical sphincterotomy and further studies that correlate between the thickness and texture of IAS and the healing response to chemical sphincterotomy recommended.

Article Info

Article Type

Research Article

Publication history

Received: Fri 09, Oct 2020
Accepted: Mon 19, Oct 2020
Published: Mon 02, Nov 2020

Copyright

© 2023 Ashraf Talaat Youssef. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.SCR.2020.11.01