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Fisuras anales

Fisuras anales. Sabiston Textbook of Surgery , 17th edition , 2005, ed Elsevier ; 1491-1495. Ulcera lineal Mitad inferior del canal anal Comisura posterior, línea media Mujeres. Epitelio escamoso Asociado: E xterno: hemorroide centinela Interno: papila anal. Crohn. etiología.

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Fisuras anales

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  1. Fisuras anales SabistonTextbook of Surgery, 17th edition, 2005, edElsevier; 1491-1495.

  2. Ulcera lineal • Mitad inferior del canal anal • Comisura posterior, línea media • Mujeres

  3. Epitelio escamoso • Asociado: • Externo: hemorroide centinela • Interno: papila anal. • Crohn

  4. etiología • Desconocida • Hipertonia del esfinter anal • Isquemia de mucosa

  5. etiología • Dieta • Cirugía anal previa • Parto • Laxantes

  6. diagnóstico • Dolor • Hematoquezia • Aumento del tono anal • Fisura • Constipación

  7. tratamiento • Agudo • 3 a 6 semanas • Crónico

  8. Tratamiento agudo • Baños de asiento • Dieta alta en fibra • 87 %

  9. Tratamientocrónico • Nitroglicerina • Dinitrato de isosorbide • 70 % • Toxina botulinica

  10. Tratamientoquirúrgico • Esfinterectomia interna parcial • Abierto • cerrado • Colgajo de avance anorrectal • Presión anal baja • Esfinterectoma previa

  11. complicaciones • Retencíón urinaria • Sangrado • Abscesos • Incontinencia • Recurrencia 10 %

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