{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T14:59:48Z","timestamp":1782485988772,"version":"3.54.5"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[1996,1,1]],"date-time":"1996-01-01T00:00:00Z","timestamp":820454400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1996,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Microvascular perfusion of the anoderm was assessed by laser Doppler flowmetry in 27 patients with anal fissure. Anal pressure was recorded simultaneously. Both measurements were repeated 6 weeks after lateral internal sphincterotomy and compared with those obtained from 27 controls. Mean(s.d.) maximum anal resting pressure was significantly higher in those with a fissure than in controls (121.07(24.48) versus 68.78(16.97) mmHg, P&amp;lt; 0.001). Anodermal blood flow at the fissure site was significantly lower than at the posterior commissure of the controls (0.46(0.20) versus 0.76(0.28) V, P&amp;lt;0.001). The fissure healed in 24 patients within 6 weeks of sphincterotomy. In these patients a significant pressure decrease was noted (35 per cent) which was accompanied by a consistent rise in blood flow (65 per cent) at the original fissure site. The increased internal sphincter tone in patients with a fissure reduces anodermal blood flow at the posterior midline. Reduction of anal pressure by sphincterotomy improves anodermal blood flow at the posterior midline, resulting in fissure healing. These findings provide evidence for the ischaemic nature of anal fissure.<\/jats:p>","DOI":"10.1002\/bjs.1800830120","type":"journal-article","created":{"date-parts":[[2007,3,1]],"date-time":"2007-03-01T10:45:34Z","timestamp":1172745934000},"page":"63-65","source":"Crossref","is-referenced-by-count":219,"title":["Ischaemic nature of anal fissure"],"prefix":"10.1093","volume":"83","author":[{"given":"W R","family":"Schouten","sequence":"first","affiliation":[{"name":"Department of Surgery, University Hospital Dijkzigt , Dr Molewaterplein 40, 3015 GD Rotterdam,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J W","family":"Briel","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Hospital Dijkzigt , Dr Molewaterplein 40, 3015 GD Rotterdam,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J J A","family":"Auwerda","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Hospital Dijkzigt , Dr Molewaterplein 40, 3015 GD Rotterdam,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E J R","family":"de Graaf","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Hospital Dijkzigt , Dr Molewaterplein 40, 3015 GD Rotterdam,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[1996,1,1]]},"reference":[{"key":"2024092816000771100_bib1","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1002\/bjs.1800730609","article-title":"Anal hypertonia in fissures: cause or effect?","volume":"73","author":"Gibbons","year":"1986","journal-title":"Br J Surg"},{"key":"2024092816000771100_bib2","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1007\/BF02554725","article-title":"Topography of the inferior rectal artery: a possible cause of chronic, primary anal fissure","volume":"32","author":"Klosterhalfen","year":"1989","journal-title":"Dis Colon Rectum"},{"key":"2024092816000771100_bib3","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1007\/BF02054409","article-title":"Relationship between anal pressure and anodermal blood flow. The vascular pathogenesis of anal fissures","volume":"37","author":"Schouten","year":"1994","journal-title":"Dis Colon Rectum"},{"key":"2024092816000771100_bib4","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1007\/BF02553100","article-title":"Anal sphincteric pressure in fissure-in-ano before and after lateral internal sphincterotomy","volume":"25","author":"Cerdan","year":"1982","journal-title":"Dis Colon Rectum"},{"key":"2024092816000771100_bib5","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1016\/S0016-5085(19)32882-3","article-title":"Internal anal sphincter derangement with anal fissures","volume":"67","author":"Nothmann","year":"1974","journal-title":"Gastroenterology"},{"key":"2024092816000771100_bib6","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1002\/bjs.1800640204","article-title":"The internal sphincter and anal fissure","volume":"64","author":"Hancock","year":"1977","journal-title":"Br J Surg"},{"key":"2024092816000771100_bib7","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1016\/0002-9610(77)90445-7","article-title":"Anal pressures in hemorrhoids and anal fissure","volume":"134","author":"Arabi","year":"1977","journal-title":"Am J Surg"},{"key":"2024092816000771100_bib8","first-page":"111","article-title":"Manometrische Untersuchungen des Analkanals vor und nach der Behandlung durch Dehnung oder Sphincterotomie","volume":"49","author":"Fischer","year":"1978","journal-title":"Chirurg"},{"key":"2024092816000771100_bib9","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1002\/bjs.1800731123","article-title":"Internal sphincterotomy for chronic anal fissure: long term effects on anal pressure","volume":"73","author":"Chowcat","year":"1986","journal-title":"Br J Surg"},{"key":"2024092816000771100_bib10","first-page":"636","article-title":"Does psychological and pain stress affect anorectal motility and external sphincter activity in humans?","volume":"76","author":"Kumar","year":"1989","journal-title":"Br J Surg"},{"key":"2024092816000771100_bib11","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1002\/bjs.1800800650","article-title":"Pharmacological study of the internal anal sphincter in patients with chronic anal fissure","volume":"80","author":"Regadas","year":"1993","journal-title":"Br J Surg"}],"container-title":["Journal of British Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fbjs.1800830120","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fbjs.1800830120","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/83\/1\/63\/59417437\/bjs1800830120.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/83\/1\/63\/59417437\/bjs1800830120.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,28]],"date-time":"2024-09-28T16:00:18Z","timestamp":1727539218000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjs\/article\/83\/1\/63\/6167379"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1996,1,1]]},"references-count":11,"journal-issue":{"issue":"1","published-online":{"date-parts":[[1996,1,1]]},"published-print":{"date-parts":[[1996,1,1]]}},"URL":"https:\/\/doi.org\/10.1002\/bjs.1800830120","relation":{},"ISSN":["0007-1323","1365-2168"],"issn-type":[{"value":"0007-1323","type":"print"},{"value":"1365-2168","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[1996,1]]},"published":{"date-parts":[[1996,1,1]]}}}