Anal fissure: a common cause of anal pain.

herman Villalba, MD, (left) is a resident in the Department of Surgery, los Angeles Medical Center in California. E-mail: [email protected]. Sabrina Villalba, MD, (center) is a resident in the Department of Family Medicine, los Angeles Medical Center in California. E-mail: [email protected]. Maher A Abbas, MD, fACS, fASCRS, (right) is an Assistant Clinical Professor of Surgery at the University of California, los Angeles; Chief of Colon and Rectal Surgery and Education Chair in the Department of Surgery at the los Angeles Medical Center. E-mail: [email protected]. Vignette A patient presents with severe anal pain, lasting hours after each bowel movement. She notices some intermittent bleeding with defecation. She comes to the office with the presumed diagnosis of hemorrhoids. Are her symptoms consistent with hemorrhoidal disease, or does she have another disorder?