Management of recurrent complicated fistula-in-ano with partial fistulotomy and ksharasutra – a case report

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A fistulainano is an abnormal hollow tract or cavity that is lined with granulation tissue and that connects a pr mary opening inside the anal canal to a secondary tract primary opening 1. In Ayurveda bhagandaracult to manage and recurrence after surgery is very high. This case history demonstrates the recurrence of fistula in ano after multiple surgeries and its successful ayurvedic management in year old male patient was diagnosed to have fistula in ano since 2 years, Patient complained of constipation with difficulty in passing stool; associated with pus discharge, pain. He presented with a history of fever s MRI – fistulogram report suggestive of a complicated fistula. Patient past history r 6 anorectal surgeries, among them one for fissure in ano, two times for haemo surgeries for fistula in ano, in a span of 2 years. He underwent fistulotomy 3 times but had recurrence of the fi tula. Based on these factors patient was treated with Apamarga Ksharasutra pr dressing with jathyadi taila, and followed by Ab shamana chikitsa. After the 3 months of therapy fist Ksharasutra helped in simultaneous cutting and healing of the fistulous tract without ther, administered drugs acted as laxative, anti Keywords: Mahagadha, complicated fistula INTRODUCTION Most fistulas are thought to arise as a result of cry toglandular infection with resultant per scess