Partial Fistulectomy and Ksharsutra in Complex Anterior Horseshoe Fistula-in-Ano - A Case Report

Abstract

Bhagandar (Fistula-in-Ano) is explained as one among Ashta Mahagada in Sushruta Samhita. This disease is recurrent in nature which makes it more difficult for treatment. Ksharsutra has been already proved in the management of fistula-in-Ano though Acharya Sushruta explained in the context of Nadi-Vrana (sinus). A 21year old female patient came to Shalya Tantra OPD with complaints of multiple boils at perianal region associated with pain and blood mixed pus discharge since, two months. On PRE multiple external openings present anteriorly between 2 to 10 0’clock,  internal opening palpated at 12 0’clock. TRUS done, suggestive of Horseshoe fistula-in-Ano. Patient was treated with partial-fistulectomy with Ksharsutra application under Sadal block. Ksharsutra was changed by weekly interval by railroad technic. Whitin 8weeks wound was healed completely and without any recurrence.