title: Anal fissure in children: a 10-year clinical experience with nifedipine gel with lidocaine.
abstract: BACKGROUND
  We aimed to evaluate efficacy and safety of the use of nifedipine gel with lidocaine in the treatment of acute anal fissures in children by reviewing the cases of 106 children with acute anal fissure treated conservatively by nifedipine gel with lidocaine between the years 2003-2012.
  
  
  METHODS
  The patients included in this study were 48 males and 58 females. Their clinical presentation consisted of constipation, rectal bleeding, anal pain, perianal itching, abdominal pain, irritability and rectal prolapse. Posterior, anterior, both anterior and posterior, multiple, both posterior and lateral locations were the main physical findings in 65, 23, 10, 7, and 1 cases.
  
  
  RESULTS
  Ninety-nine patients completed the 4-week treatment course of nifedipine gel with lidocaine successfully (93.40%), with complete healing of the fissure. The recurrence rate observed was very low (6.60%).
  
  
  CONCLUSIONS
  Topical 0.2% nifedipine with lidocaine appears an efficient mode of treatment for anal fissures in children, with a significant healing rate and no side effects.
authors.affiliation: Pediatric Division, Assaf HaRofeh Medical Center, Tzrifin, Israel - abukishk_i@yahoo.com.
authors.forename: Baruch
authors.initials: B
authors.lastname: Klin
authors.forename: Yigal
authors.initials: Y
authors.lastname: Efrati
authors.forename: Matitiahu
authors.initials: M
authors.lastname: Berkovitch
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Abu-Kishk
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D004338:Drug Combinations; D005260:Female; D005401:Fissure in Ano / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007223:Infant; D008012:Lidocaine / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D009543:Nifedipine / Q000008:administration & dosage* / Q000009:adverse effects; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000009:adverse effects; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D000779:Anesthetics, Local; D004338:Drug Combinations; D014665:Vasodilator Agents; D008012:Lidocaine; D009543:Nifedipine