Pipop Jirapinyo MD*, Narumon Densupsoontorn MD*, Channagarn Kangwanpornsiri MD*
Affiliation : * Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : To study the association between anal fissures and cow’s milk allergy (CMA) in infants.
Methods and Method: In a prospective study, 72 confirmed cases of CMA in infants were examined for anal fissure by
pediatricians with five years’ experience. A positive finding was defined as when an anal fissure was detected by at least
two out of three examiners.
Results : Of infants with CMA with and without gastrointestinal GI symptoms, 79% and 83% had anal fissures, respectively.
The prevalence of anal fissure in these infants is significantly higher than in normal infants.
Conclusion : Anal fissure may be a pathognomonic sign of cow’s milk allergy in infants.
Keywords : Anal fissure, Cow’s milk allergy, Diagnosis, Pathognomonic sign
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