Abstract
BACKGROUND: Anal fissure, fistula-in-ano, and anorectal abscess are common benign anorectal conditions that contribute substantially to pain, morbidity, repeated hospital visits, and procedure-related workload in surgical practice. Because these conditions differ in presentation, anatomical characteristics, and treatment pathways, institution-specific data on their clinical profile and early outcomes are useful for improving decision-making and follow-up in tertiary care settings. OBJECTIVES: To describe the clinical profile and symptom pattern of patients with anal fissure, fistula-in-ano, and anorectal abscess, and to assess treatment outcomes and early recurrence in a tertiary care hospital. METHODS: A hospital-based retrospective observational study was conducted in the Department of General Surgery, Al-Ameen Medical College and its associated teaching hospital, Vijayapura, Karnataka, using hospital records from the study period 2024-2025. Adult patients aged 18 years and above with a documented diagnosis of anal fissure, fistula-in-ano, or anorectal abscess were included. Haemorrhoidal disease was not included because the study was intentionally restricted to these three conditions, which differ from haemorrhoids in pathophysiology, clinical course, management algorithms, and outcome assessment. Demographic details, presenting symptoms, disease subtypes, treatment received, and follow-up outcomes were extracted from case records using a structured data collection format. Outcome measures included symptom resolution, wound healing, postoperative complications, and recurrence. Categorical variables were analysed using the chi-square test, with p < 0.05 considered statistically significant. RESULTS: A total of 162 patients were included. Anal fissure accounted for 58 cases (35.8%), fistula-in-ano for 54 (33.3%), and anorectal abscess for 50 (30.9%). Chronic fissure was seen in 39/58 (67.2%). Simple low fistulas comprised 37/54 (68.5%), while 17/54 (31.5%) were complex. Perianal abscess was the most frequent abscess subtype (76%). Pain was common in fissure and abscess, discharge predominated in fistula, and swelling with fever was strongly associated with abscess (p < 0.05). Overall, symptom relief exceeded 85% across groups. Recurrence was low after fissure surgery and comparatively higher in fistula cases. CONCLUSION: Selected benign anorectal conditions presented in nearly comparable proportions, with distinct symptom profiles that supported clinical diagnosis. Standard treatment protocols achieved high short-term success, while fistula disease showed a greater tendency toward recurrence, underscoring the need for careful anatomical assessment and follow-up.