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Message: <blockquote data-quote="Miga" data-source="post: 20194633" data-attributes="member: 216106">Mehemai eka chronic da actute kiyala decide karanna podi history ekak onee?Chronic anal fissure kiyanne  godak kalayak fissure eka thiyanawanam ...classically " sentinel tag present distally - eka thamai classical feature eka ( anal canal (sphinter) eka eliye gatayak wage thiyenawda? <img src="https://www.google.lk/search?q=sentinel+tag&newwindow=1&biw=911&bih=445&source=lnms&tbm=isch&sa=X&ved=0ahUKEwjXxZfO6PfMAhWHpZQKHSYHC-QQ_AUIBigB#imgrc=kmM2zyPMGHueGM%3A" alt="" class="fr-fic fr-dii fr-draggable " style="" />mehema ekak thiyanawanm oyata thiyenne "chronic anal fissure" , mehema kiyanna amarui hariyata history ekak one malli , acute anal fissure nam significantly painful (nikan kambi katuwak anal sphinter eka athulen yanatharam ridenawa) chronic anal fissure nam ehema pain ekak na.. ara kiwwa sentinel tag eka thiyenawaUba surgeon kenek meet wenna giyada? eya Diagnose karada? usually ( Proctoscopy or sigmoidoscopy karala balanawa anal canal eka under General anesthesia Ita passe Surgeon decide karanawa initially1) Treat constipation ( stools loose karanawa)2) Local anesthesia ( lidnocaine jelly)3) GTN and CCB wage drugs deela balanawaMain objective is to treat conservatively surgery karanne nathuwa ..90% kattiya mekata respond karanawa , ehema karanne naththam last thamai surgery walata yanne, eka loku surgery ekakuth nemei e gana baya wenna epa , hari doctor kenek meet wenna , ME ABOVE STEPS WALIN KARANNE SYMPTOMATICALLY TREAT KARALA BALANA EKA If conservative managment fails, we go for surgeryDrugs walata answer karanne naththam 1) Anal dilation karanna puluwan2) lateral anal sphinteroctomy ( sphinter eka partially ain karanawa_3) anal advancement flapme tika surgeon n oya katha karala oyaa hariyana ekak decide karanna , ELA ...mata Pm karanna , oya hari surgeon kenek hambawenna meka loku prashnyak nemei , meka thawa thiyan inna acess ennath puluwan or develop to a fistula eka nisa ikmanata treat karanna</blockquote>

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