Anal fissure fissure-in-ano is a very common anorectal condition. The exact etiology of this condition is debated; however, there is a clear association with elevated internal anal sphincter pressures. Though hard bowel movements are implicated in fissure etiology, they are not universally present in patients with anal fissures. Half of all patients with fissures heal with nonoperative management such as high fiber diet, sitz baths, and pharmacological agents. When nonoperative management fails, surgical treatment with lateral internal sphincterotomy has a high success rate.
The Sentinel Pile of Ball —Not Brodie
Piles: Symptoms, causes, and treatments
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Long Beach, Calif. Leon Banov, and also of your editor , ; , ? The sentinel pile was not described by Sir Benjamin Brodie, and so it is not surprising that the 19th-century textbooks on rectal diseases make no mention of it in association with Brodie's name. The little torment was, however, described by Sir Charles Ball, professor of surgery at the University of Dublin. He first propounded his theory as to its causation in cases of fissure in his book, The Rectum and Anus: Their Diseases and Treatment.