Investigations

1st investigations to order

clinical diagnosis

Test
Result
Test

Usually no tests are necessary at initial presentation.

Result

features of anal fissure

Investigations to consider

anal manometry

Test
Result
Test

Should be performed in patients with resistant fissures, as the choice of second-line treatment depends on resting pressure.[3][16]​ Anal manometry should be considered in women who have had obstetric injury (third-degree tear).

Result

low resting pressure

anal ultrasound

Test
Result
Test

Patients with suspected anal sphincter deficits, who are found to have an anal fissure on examination, should not be subjected to further sphincter damage by sphincterotomy.[3][16]

Result

defects in internal or external anal sphincter

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