Abstract

APPROACH TO DEAL WITH COMPLEX FISTULA IN ANO- A CASE STUDY

Shweta Dethe*, Neha Satpaul, Swati Kadam and Piyush Mathariya

ABSTRACT

Fistula in ano is a common anorectal condition prevalent in the population worldwide. Ideal surgical treatment have aim to eradicate sepsis and promote healing of the tract whilst preserving the sphincters and mechanism of continence. In modern surgical procedures such as Fistulotomy, Fitulectomy to treat fistula in ano has high rate of recurrence and anal incontinence. Other operative techniques such as LIFT, VAAFT, Colostomy are very much costly that these are out of the limit of a common man. In Ayurveda, this condition resembles with ‘Bhagandara’ which is considered as Ashtamahagada (Eight grave disorder).[1] Alternatively, a nonsurgical cost effective treatment with Ksharsutra (a cotton seton coated with Ayurvedic medicine) has minimal complications. In this case study, an effort is made to treat a 45 years male diagnosed as complex fistula with oral medication and Apamarga Ksharsutra ligation under spinal anaesthesia along this Dhupan karma done for 1 year. This shown positive response by slow cutting of fistula track & simultaneously healing of wound from behind.

Keywords: LIFT(Ligation of intersphincteric fistula track), VAAFT(Video-assisted anal fistula treatment), Bhagandar, Ashtamahagada, Ksharsutra, Dhupan karma.