Anal fissure
ICD-10 K60.0 · ICD-11 DB50.0

Chronic Anal Fissure in Children Under 16 Years

Clinical scenario

This protocol addresses the management of chronic anal fissure in paediatric patients under 16 years of age. A different treatment algorithm from that used in adults is advisable for this age group.

Why age matters here

Children under 16 with a chronic anal fissure require a dedicated clinical approach. A different treatment algorithm for children (U16) with a chronic anal fissure is advisable.

Treatment approach — partial overview
The structured regimen for this scenario involves an intrasphincteric injection-based intervention. Full treatment details — including eligibility criteria, sequence, and all options — are available in the complete protocol.
Complete regimen, dosing guidance, and decision pathway not shown here.
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References

DOI: 10.1111/codi.167

  • A different treatment algorithm for children (U16) with a chronic anal fissure is advisable.
  • First-line treatment on acute anal fissures in children is the use of stool softeners and/or stimulant laxatives; followed by topical agents or intrasphincteric injection of botulinum toxin.
  • One report describes this intervention in 13 children, using 2.5 U Botox x2 in >2 year old, either side of the fissure into the external sphincter using EMG stimulation as guidance.
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