title: Injection of a sclerosing agent as first line treatment in anal fissure.
abstract: BACKGROUND
  In our institution, the first line treatment in acute anal fissures (AAF) or chronic anal fissures (CAF) is the injection of a sclerosing agent consisting of phenol, menthol and peanut oil (Phenomen®, Sterop laboratory, Belgium) under the fissure after a local anaesthesia. This retrospective study presents the technique of injection, evaluates its efficacy and demonstrates the minimal occurrence of complications, continence problems and recurrences.
  
  
  METHODS
  129 patients with an anal fissure were treated between January 2010 and June 2011. 124 patients were reviewed retrospectively. 109 patients benefited from a sclerosis in our outpatient clinic.
  
  
  RESULTS
  Of the 109 patients treated by a sclerosis, 58 had an AAF and 51 had a CAF. 53/58 AAF (91.4%) healed and 40/51 CAF (78.4%). Duration of pain after injection was 2 days or less in 55 cases (50.4%), 1 week or less in 35 cases (32.2%) and more than 1 week in 19 cases (17.4%). The complication rate was low (2.7%) : 2 necrosis of the skin and 1 abscess at the site of injection. The rate of troubles of continence was 2.7% : 2 cases of soiling and 1 case of incon-tinence for gas all resolving within a month. At the end of the study, a fissure had recurred in 17 patients (15.6%).
  
  
  CONCLUSIONS
  The injection of a sclerosing agent under the fissure is performed in the practitioner's office. Healing rates are high, complications and recurrences are low. This therapeutic option may be a good alternative to classical treatments in case of anal fissures.
authors.affiliation: Department of digestive surgery and proctology, Centre hospitalier universitaire de Tivoli, La Louvière, Belgium.
authors.forename: M
authors.initials: M
authors.lastname: Dessily
authors.forename: F
authors.initials: F
authors.lastname: Charara
authors.forename: E
authors.initials: E
authors.lastname: Chelala
authors.forename: A-L
authors.initials: AL
authors.lastname: Donfut
authors.forename: J-L
authors.initials: JL
authors.lastname: Allé
mesh_terms: D000328:Adult; D000368:Aged; D003672:Defecation; D004338:Drug Combinations; D005242:Fecal Incontinence / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D005260:Female; D005401:Fissure in Ano / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D005500:Follow-Up Studies; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012597:Sclerosing Solutions / Q000008:administration & dosage*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D004338:Drug Combinations; D012597:Sclerosing Solutions