CLINICAL PRESENTATION OF CHRONIC ANAL FISSURES

Chronic anal fissures have a varied and often confusing clinical prese ntation. To clarify this picture, we retrospectively studied 172 patie nts to determine associations between patient characteristics and mani festations of these lesions. We found that anterior fissures and senti nel piles were significantly more common in women; pruritus and rectal drainage occurred significantly more often in men; and patients with a longer duration of symptoms and those with pruritus and drainage wer e more likely to have a fistula. Younger patients were more likely to report rectal bleeding. Patients with chronic anal pruritus or an anal abscess should be carefully evaluated for an anal fistula, since anor ectal problems may recur if a fistula remains untreated.