Management of Unmargi Bhagandar (Fistula-in-ano with foreign body) - A rare Case Report and Review of Literature

Abstract

The clinical features of Bhagandar resembles with Anal Fistula i.e. discharge of pus and blood or blood mixed pus discharge, pain(throbbing), itching in perianal region, backache, fever, etc. In modern science the most widespread and useful classification of Anal fistulae proposed by Park are- Intersphincteric Fistula, Trans-sphincteric Fistula, Supra-sphincteric Fistula, Extra-sphincteric Fistula ^[1,2].  In Ayurveda, 8 types of fistulae are mentioned depending on its track and on nature of discharge seen - Shatponak, Ushtragreeva, Parisravi, Shambukavarta, Unmargi, Parikshepi can be classified as complex Anal fistulae while Rujju and Arsho-Bhagandar as Simple fistulae due to their linear tracts. In this case study a 33 years old male patient predominantly a non-vegetarian comes with an ill- treated and misdiagnosed anal condition is diagnosed to have Unmargi Bhagandar and treated as directed in Sushruta Samhita. This proves how age old narrated Nidanpanchak and management of Bhagandar holds true and practical even in today’s world of Proctology