CLINICAL EFFICACY OF KSHAR SUTRA IN COMPLEX SCROTO ANAL FISTULA – A SINGLE CASE STUDY

Fistula-in-ano is an inflammatory track which has an external opening in the perianal skin and internal opening in the anal canal or rectum. The track is lined by unhealthy granulation tissue and fibrous tissue. As per Ayurvedic perspective the condition can be corelated with Bhagandara. Acharya Sushruta has categorised Bhagandara under the heading Ashtomahagada as it is difficult to cure. Acharya Sushruta mentioned Chhedan Karma i.e. excision of fistula tract as a general treatment for all types of fistula.[1] He has also stated use of Ksharsutra for the management of Bhagandara.[2] Keping this basic principals in mind, a single case study of 37 years old male patient, suffering from complicated Scroto- anal Fistula with multiple external openings in perineum has been treated successfully here. Patient had complaints of discharging boil in perianal region with intermittent pus discharge. On detail history and thorough examination and as per MRI findings, the patient was diagnosed as a case of complicated scrota-anal fistula. Partial fistulectomy with standard Apamarga Kshar sutra ligation was planned for this case under spinal anaesthesia with proper adjuvant medications. The patient was completely cured at the end of six months with no recurrence till date.