Abstract
The anal fissure is the most frequent acquired disease of the rectum and anus in the childhood and the most frequent cause of bleeding from rectum in children. The source of bleeding is damaged mucosa of anal channel.
It occurs most frequently between six months and two years of life. Most common symptoms are rectal bleeding, pain and retaining of stool.
Fissure can be acute or chronic. The diagnosis is made from clinical picture and physical examination of anus and its surrounding .An endoscopy examination is necessary to confirm an uncertain working diagnosis of anal fissure or to rule out bleeding from another source.
The treatment consists of relief of the spasm of the anal sphincter and healing of the fissure. An endoscopy is necessary in recurrent fissure bleeding or poor response to the treatment.
Surgical treatment, fissure excision and sphincteromyotomy of internal anal sphincter is indicated in chronic fissures. Botulotoxin treatment is not used in children.