| CASE REPORT |
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| Year : 2020 | Volume
: 3
| Issue : 1 | Page : 10-13 |
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Management of Riju bhagandara (trans-sphincteric anal fistula) by modified conventional Ksarasutra therapy
P Sreenadh, Vyasadeva Mahanta, Rahul Sherkhane, Sanjay Kumar Gupta
Department of Shalya Tantra, All India Institute of Ayurveda, New Delhi, India
Correspondence Address:
Dr. Vyasadeva Mahanta
Department of Shalya Tantra, All India Institute of Ayurveda, New Delhi
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/JACR.JACR_6_20
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Management of anal fistula is always a big challenge for surgeons due to recurrence and associated anal incontinence. In spite of various advancements, failure rate is high even after surgery. Ksarasutra therapy is accepted as a successful modality with high cure rate in the management of anal fistula. In this case, a 45-year-old, hypertensive, and diabetic male patient visited to Shalya tantra outpatient department with complaints of intermittent pus discharge from the peri-anal region for seven months. On local examination, an external opening covered with hyper-granulation and pus discharge was observed nearer to the base of scrotum at approximately eight cm away from the anterior anal verge. On palpation, a thick fibrous cord-like structure was felt extending from the anal canal to the base of scrotum. On per rectal examination (P/R) examination, a tender point was felt at the 12'o clock position just above the dentate line. Magnetic resonance imaging revealed a trans-sphincteric anal fistula with internal opening at the 12 o' clock position and was managed by Modified Conventional Ksarasutra technique. The tract was completely healed within five weeks. No fecal incontinence was reported by the patient, nor signs of recurrence were observed after six months of follow-up.
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