A CASE REPORT OF A SIMPLE TRANSPHICTERIC FISTULA-IN ANO AND ITS MANAGEMENT THROUGH PARTIAL FISTULOTOMY FOLLOWED BY KSHARA SUTRA APPLICATION

Bhangandara is one of the Ashta Mahagada described by Acharya Susrutha.[1] Gada Nigraha describes Nirukti of Bhagandara as “Vrushanaasanayormadhyapradesho bhagamuchyate, tameva dhaarayettasmaadbhagandara iti smrutaha”.The darana of vrushanasana madhya sthita bhaga is Bhagandara.[2] “Bhagagudabasti pradeshadaaranat cha bhagandara iti uchyante, abhinnaaha pidakaha, bhinnastu bhagandaraha," states Sushruta. Pidakas created at Bhaga, Guda, and Basti Pradesha go through suppuration, explode, and create an aperture known as Bhagandara.[3] Bhagandara is divided into Shataponaka, Ushtragreeva, Parisravi, Shambookavarta, and Unmargi by Acharya Susrutha.[4] In contemporary science, it is contrasted with fistula-in-ano. It is an inflammatory track that has an internal opening in the rectum or anal canal and an exterior opening in the perianal skin. In ano, the average incidence of non-specific fistula is 8.6 cases per 1,00,000 people, with 12.3 instances in men and 5.6 in women. A perianal abscess brought on by a cryptoglandular infection is typically where it starts. Fistula-in-ano is the result of its spontaneous rupture.[5] One kind of fistula is a transphincteric fistula, which extends across anal sphincters, both internal and external. A clinical method called Goodsall's rule is used to forecast how an anus fistula will progress. A 30 years old male patient approached to Shalya Tantra OPD complains of pus discharge and itching in the base of left side of the scrotal region which was on and off in nature since 1 month was examined thoroughly and was diagnosed as Fistula-in-ano for which partial fistulotomy followed by Kshara sutra was done and the Kshara sutra was changed once in a week and wound was healed completely.