Abstract
KSHARASUTRA- ASSISTED TRACT NAVIGATION: A GUIDEWIRE-BASED TECHNIQUE IN MANAGEMENT OF COMPLEX FISTULA IN ANO: A SINGLE CASE STUDY
Dr. Maithreyee* and Dr. Sheshashaye B.
ABSTRACT
Acharya Sushrutha defined Bhagandara as “Bhagagudabasthipradeshadaaranat cha bhagandara”[1] The Nidana (causative factors), Lakshana (clinical features), Samprapti (pathogenesis), Bheda (types), and Chikitsa (management) of Bhagandara have been extensively detailed by Acharya Sushruta, and can be correlated with the modern understanding of fistula-in-ano.[2] Fistula-in-ano is characterized as an abnormal tract between two epithelial surfaces, commonly presenting with one or more external openings in the perianal region connected to the anal canal or rectum. This tract is lined by unhealthy granulation tissue and fibrous tissue.[3] Bhagandara is classified among the Ashtamahagada[4] (eight major diseases) by Acharya Sushruta, highlighting its chronic and challenging nature in terms of treatment. Several modern risk factors such as prolonged sitting, use of hard seating surfaces, and frequent travel on vehicles have been found to contribute to its development. While Acharya Charaka has provided limited discussion on this topic, he does mention Krimi[5] (parasitic infection) as a possible causative factor. Direct reference about kshara sutra in management of Nadivrana and Bhagandara.[6]
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