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Feingold means every word. Atypical fissures can be multiple, deep, wide; have irregular margins; and may present with purulent drainage from the anus. Canadian Medical Association Journal. Releasing a portion of the muscle yields rapid symptomatic relief and heals the fissure. American Society of Colon and Rectal Surgeons. Evaluation The diagnosis of anal fissure is often made on the basis of the patient's medical history. Pathophysiology and Presentation An anal fissure is a tear or a cut in the anoderm Figure 1.

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