RESIDENT’S CORNER Emily Steinhagen, M.D. Division of Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio CASE SUMMARY: A 30-year-old otherwise healthy decreases blood flow to the area and prevents healing once a woman presents with 1 week of pain, “like passing fissure has formed. The association between fissures and hy- glass,” with defecation and bright red blood with bowel pertonic sphincters has been demonstrated manometrically, movements. She typically has hard stools. as has the association between hypertonic sphincter and de- creased blood flow to the anoderm. CLINICAL QUESTIONS PRESENTATION The most frequent symptom for fissure patients is sharp • What are the presenting signs and symptoms of anal pain. Patients may describe having a bowel movement like fissure? passing glass or razor blades. The pain is worst with, and • What are the medical and surgical treatment immediately after, bowel movements. In more chronic options? cases, constant pain may be reported as muscular hyper- trophy occurs and sphincter spasm begins to contribute to the pain process. Patients often report bright red blood BACKGROUND either streaking the stool or when wiping. On physical examination, patients with an acute fis- Anal fissures are longitudinal tears in the anal canal, distal sure
Diseases of the Colon & Rectum – Wolters Kluwer Health
Published: Mar 1, 2018
It’s your single place to instantly
discover and read the research
that matters to you.
Enjoy affordable access to
over 18 million articles from more than
15,000 peer-reviewed journals.
All for just $49/month
Query the DeepDyve database, plus search all of PubMed and Google Scholar seamlessly
Save any article or search result from DeepDyve, PubMed, and Google Scholar... all in one place.
Get unlimited, online access to over 18 million full-text articles from more than 15,000 scientific journals.
Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.
All the latest content is available, no embargo periods.
“Hi guys, I cannot tell you how much I love this resource. Incredible. I really believe you've hit the nail on the head with this site in regards to solving the research-purchase issue.”Daniel C.
“Whoa! It’s like Spotify but for academic articles.”@Phil_Robichaud
“I must say, @deepdyve is a fabulous solution to the independent researcher's problem of #access to #information.”@deepthiw
“My last article couldn't be possible without the platform @deepdyve that makes journal papers cheaper.”@JoseServera