Abstract

A COMPLEX FISTULA-IN -ANO CURED WITH IFTAK (INTERCEPTION OF FISTULOUS TRACT WITH THE APPLICATION OF KSHAR SUTRA) TECHNIQUE-A CASE REPORT

Poonam Sharma*, Ashutosh Yadav and Suman Yadav

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Abstract

Background - Fistula in ano, also known as anal fistula, is a type of fistula that forms between the anal canal and perianal area. It typically occurs as a result of an infection or abscess in the anal glands, resulting in the formation of tunnel or passage. This condition is characterised by symptoms such as presence of an opening near anus, which may discharge pus, stool, blood along with pain, swelling, redness, and discomfort in anal area. Treatment usually involves surgical techniques, such as fistulectomy, fistulotomy, seton placement, advancement flaps, or ligation of the intersphicteric fistula tract, are employed based on specific case. However, treatment of fistula in ano without compromising anal continence can be difficult to surgeon. Case Presentation – Here, we present a case of fistula in ano of complex clinical appearance managed successfully by IFTAK (interception of fistulous tract with the application of kshar sutra). In this case, diagnosis of fistula in ano confirmed by digital rectal examination, probing of tract. The patient showed tremendous improvement and fistula healed completely without compromising anal continence. At about 3 month of follow-up patient was healthy and no reoccurrence was found. Conclusion- IFTAK (interception of fistulous tract with the application of kshar sutra) is a minimally invasive technique and it is very effective for managing complex fistula in ano of cryptoglandular in origin without compromising sphincter mechanism and anal continence. Main cause of recurrence of fistula is not identification of infected anal crypts, failure of proper drainage of tract, secondary extension. So proper diagnosis and appropriate surgical measures play an equal role in the treatment of fistula in ano.

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