Original CommunicationsIdentification of anti-endothelial cell antibodies in patients with chronic anal fissure☆
Section snippets
Material and methods
This study was carried out on patients with chronic anal fissure between June and December 1996. In each case an accurate clinical history was taken. Subjects with a personal or family history of the following were excluded: heart disease, vascular disease, hypertension, obesity, smoking, diabetes, lipidemia, autoimmune disease or other immune disorders, allergies, arthritis and collagen disorders, systemic inflammatory disease or inflammatory bowel disease, hepatic disease, recent surgery or
Results
Group 1 consisted of 10 patients (4 men and 6 women of mean age 43 ± 14.6 years), group 2, of 10 patients (6 men and 4 women of mean age 43.5 ± 15.8 years), and group 3, of 10 volunteers (6 men and 4 women of mean age 48.4 ± 8.9 years) without anorectal disease. The groups were homogeneous as to age and gender distribution. The duration of symptoms was 21.3 ± 12.2 months (minimum, 5; maximum, 48) in the patients in group 1 and 29.1 ± 18.7 months (minimum, 10; maximum, 60) in the patients in
Discussion
The pathogenic event in the formation of anal fissure still remains obscure. Several studies have correlated this event with reduced blood supply to the posterior commissure2, 3, 4 or with an increase in the basal anal tone.6, 7 It has, however, been observed that the fissure often occurs in the absence of increased tone17 and that, conversely, the lesions can, even if rarely, heal spontaneously.1, 5, 18 Recent studies demonstrate that the fissure can be the consequence of a local ischemic
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Reprint requests: Giorgio Maria, MD, Istituto di Clinica, Chirurgica, Policlinico Universitario A. Gemelli, Largo Agostino Gemelli, 8, 00168 Rome, Italy.