EFFECT OF PARTIAL FISTULECTOMY FOLLOWED BY KSHARASUTRA LIGATION IN THE MANAGEMENT OF BHAGANDARA (FISTULA-IN-ANO) - A CASE REPORT

*Dr. Sahana S. Joshi, Dr. Shivalingappa J. Arakeri, Dr. Syeda Ather Fathima, Dr. Mohasin Kadegaon, Dr. Geetanjali Hiremath

ABSTRACT

In Ayurveda Bhagandara literally means Darana of Bhaga, guda and basti pradesha leading to the formation of communicating tract which produces discomfort to the patient. The disease Bhgandara can be correlated to Fistula-in-ano. Treatment of Fistula-in-ano includes Fistulectomy, Fistulotomy and Seton’s plug. Ksharasutra treatment is economical, safe and has least adverse effects with negligible recurrence. A case of 40year old male patient diagnosed with Fistula-in-ano having 2 external openings at 9 and 10 O’clock approximately 6cm away from the anal verge with a single internal opening at 9 O’clock. The length of the tract was 6cm and it was treated with Partial Fistulectomy followed by ksharasutra ligation for remaining part of the tract. Ksharasutra was changed on every 7th subsequent day and post-op wound dressing was done with Jatyadi taila daily. After 3 weeks the post-op wound got healed and on 4th sitting the fistulous tract got cut through completely .Thus ksharasutra is more effective with minimal invasive surgical procedures in terms of reducing the treatment duration in the management of Bhagandara. Which is easy to perform and can be done under local anesthesia.

Keywords: Bhagandara, Fistula-in-ano, Ksharasutra, Partial Fistulectomy.