A CASE STUDY ON MANAGEMENT OF FISTULA BY PATANKARMA WITH APAMARGADI LEPA

Dr. Samir Chaudhari*

ABSTRACT

Bhagandara (fistula in ano is) considered under the Ashta Mahaarogas (Eight grave disorders).The prevalence rate of fistula-in-ano has been accepted as second highest after piles in ano-rectal disorders. Various management of Bhagandara are explained in classics among which patanakarma, one of the procedure mentioned in the Sushruta samhita chikitsa sthana (8/4) is thought to be most appropriate for the management of Bhagandara. Also Chakradutta has mentioned the patanakarma iS one of the best management of Bhagandara. This study was conducted to evaluate theeffectiveness of Patanakarma with Apamargadi lepa as the surgical management of Bhagandara (Fistula-in-ano). Material & Methods: A 38 years old male patient visited to shree RMD Ayurved College shalya OPD with pus discharge from anal regan. On examination external opening was seen at 3 o’clock approximately 4 cm from anal . Patient had history o perianal abscess. So, it was diagnosed as a case of low anal subcutanious fistula. Patankarma (fistuotomy) followed by teekshna Apamargadi lepa application under spinal anesthesia (Xylocaine 2% with adrenaline) was done. Observation And Results: The wound was assessed weekly and it was observed that in first week pain was reduced completely. On second week healthy granulation was observed without any discharge. The wound healed completely within one and half month with minimal scar formation and normal skin coloration. Conclusion: This single case study concluded that patankarma (fistulotomy) with apamargadi lepa one of the option for management of low anal subcutaneous.

Keywords: Bhagandara, Fistula-in-ano, Fistulotomy, Patankarma, Apamarga.