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Rivista di Pediatria, Neonatologia, Medicina dell’Adolescenza
e Neuropsichiatria Infantile
Indexed/Abstracted in: CAB, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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Minerva Pediatrica 2016 June;68(3):196-200
Anal fissure in children: a 10-year clinical experience with nifedipine gel with lidocaine
Baruch KLIN 1, 2, Yigal EFRATI 1, 2, Matitiahu BERKOVITCH 1, 2, Ibrahim ABU-KISHK 1, 2 ✉
1 Pediatric Division, Assaf HaRofeh Medical Center, Tzrifin, Israel; 2 Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
BACKGROUND: We aimed to evaluate efficacy and safety of the use of nifedipine gel with lidocaine in the treatment of acute anal fissures in children by reviewing the cases of 106 children with acute anal fissure treated conservatively by nifedipine gel with lidocaine between the years 2003-2012.
METHODS: The patients included in this study were 48 males and 58 females. Their clinical presentation consisted of constipation, rectal bleeding, anal pain, perianal itching, abdominal pain, irritability and rectal prolapse. Posterior, anterior, both anterior and posterior, multiple, both posterior and lateral locations were the main physical findings in 65, 23, 10, 7, and 1 cases.
RESULTS: Ninety-nine patients completed the 4-week treatment course of nifedipine gel with lidocaine successfully (93.40%), with complete healing of the fissure. The recurrence rate observed was very low (6.60%).
CONCLUSIONS: Topical 0.2% nifedipine with lidocaine appears an efficient mode of treatment for anal fissures in children, with a significant healing rate and no side effects.