Abstract

VASA KSHARASUTRA IN THE MANAGEMENT OF BHAGANDARA (FISTULA- IN-ANO) -A CASE REPORT

Dr. W. A. A. P. Wicramanayake and Prof. P. Hemantha Kumar*

Abstract

Purpose: Bhagandara is one of the commonest diseases with high recurrence rates occurring in ano-rectal region. According to Susruta Samhita Bagandara is defined as a tear in the region of perineum, rectum and pelvis which associated with pain. Bhagandara is compared to Fistula-in-ano. Even though different methods of treatments have been advocated time to time there is no any satisfactory method to treat in modern medicine. Even Bailey and Love’s Short practice of Surgery also included Ksharasutra as a treatment method for fistula‑in‑ano. Even though there are different types of Ksharasutras are described in texts mostly Apamarga Ksharasutra is using for treatment. In this case study we are using Vasa Kshara sutras as treatment for Bhagandaras. Material and Method: A 52 years old male came to OPD, Department of Shalya Tantra, NIA complaining swelling in perianal region with mild pain at the perianal region and discharge of pus since 11/2 years. By local examination it was found external opening was present at 5 O’ clock at perianal region and internal opening was at 6 O’ clock position. Partial fistulotomy was done at 6 to 5 clock position with primary threading on intersphinter space and Vasa Kshara sutra was applied. Result and Discussion: The initial length of the track was 9 cm which got cut through in 24 days which means it cutoff 2.3 cm per week. Kshara sutra therapy is very cost-effective treatment with no complications. This is sphincter saving procedure as well as easy to perform and fast acting treatment.

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