Abstract

INTEGRATIVE MANAGEMENT OF ANAL FISTULA: A CASE REPORT

Ranjan Kumar Kasta*, Bipin Bihari Khuntia and Ajit Kumar Pradhan

.

Abstract

Introduction: An anal fistula is an abnormal tract communicating the anal canal internally and perianal skin externally lined with granulation tissues. Although not life-threatening, its management is challenging due to recurrence especially. Ksharasutra therapy is a para surgical technique practiced in India for treatment of anal fistula with high success rate. Case presentation: A 56-year-old male patient came to Shalya Tantra OPD with complaint of pus discharge from the perianal region with mild pain and itching for 5 years. Examination revealed hyperpigmented left perianal skin with multiple external openings at 1’ o clock position below the scrotum approximately 4 centimeters from the anal verge, and another was at 4 ‘o clock position nearly 2 centimeters from the anal verge through which little pus was oozing and induration on palpation. Magnetic resonance fistulogram confirmed transphincteric anal fistula with multiple external opening. Patient treated through integrative approach. Ksharasutra applied after partial fistulectomy. After 10 month of treatment the fistula tract healed completely. Discussion: Fistulectomy or fistulotomy is the standard conventional treatment for anal fistula. Ksharasutra therapy is an effective and safe treatment method for healing the fistulous tract with less recurrence rate. Conclusion: Integrative approach reduced the treatment period and maintained the normal structure of the perineum with minimal scar. The patient was recovered without any inconvenience.

Keywords: Anal fistula, Fistulectomy, Ksharasutra therapy.