World Journal of
Pharmaceutical and Life Sciences

MANAGEMENT OF GAMMA SHAPED FISTULA-IN-ANO VIS A VIS BHAGANDARA BY KSHARASUTRA – A RARE CASE REPORT

Manoj D. C.* and S. V. Shailaja

ABSTRACT

Fistula-in-Ano is an inflammatory tract which has an external opening in the perianal skin & an internal opening in the anal canal or rectum. This is lined by unhealthy granulation tissue & fibrous tissue. The prevalence rate is 8.6 cases per 1,00,000 population. In Ayurveda Fistula-in-Ano can be correlated with Bhagandara which is defined as Pidakas formed at bhaga, guda and basti pradesha undergoes suppuration, bursts open and makes an opening externally. It is considered under Ashta Mahagada. Fistulotomy, Fistulectomy, Flap procedure, Laser technique etc are the procedures often adopted in contemporary science, which may require prolonged hospitalization, repeated infections and incontinence. In order to avoid these problems, there is a need for Kshara sutra ligation method as explained in Nadivrana Chikitsa of Sushrutha samhitha, which also suggests the use of the same in Bhagandara. In this case report, A female patient aged about 17 years visited OPD of Shalya Tantra of Sri Kalabyraveshwaraswamy Ayurvedic Medical college, hospital & Research center with complaints of pain and pus discharge in perianal region. High frequency USG of the perineum suggestive of a Gamma Shaped trans sphincteric fistulous track along the Right anterolateral aspect of the anal canal. Its External opening is at 10-11’0 clock position with internal opening around 12’0 clock position. It is at a depth of about 1.5 cm deep to the verge. The patient was treated with Apamarga Ksharasutra till the complete excision & healing of fistulous tract.

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