Abstract

*Dr. Ashish Kumar, Prof. Suman Yadav, Dr. Ashutosh Kumar Yadav

ABSTRACT

3a. Introduction: An anal fistula is an abnormal tract that connects the rectum or anal canal to the external perianal skin, often presenting with one or more external openings. In rare cases, the tract may communicate with more distant parts of the rectum. This condition poses a considerable clinical challenge, primarily due to its high rate of recurrence, particularly in complex or high-grade fistulas.In India, Ksharasutra therapy—a medicated seton technique rooted in Ayurvedic principles—is widely practised and has demonstrated a notably high success rate, with a reported recurrence of only 3.33%. 3b. Main Clinical: A 33-year-old female patient presented to the Shalya Tantra OPD, with complaints of a boil-like swelling in the perianal region, associated with pain, purulent discharge, and itching for the past 5–6 months. The external opening was located approximately 3–4 cm from the anal verge at the 7 o’clock position. 3c. Findings and Diagnosis: On digital rectal examination, an internal opening was palpated at the 7 o’clock position in alignment with the dentate line. 3d. Interventions: The treatment involved an innovative sphincter-sparing technique, utilising an adapted Apamarg Ksharsutra therapy to enhance healing speed and minimise post-surgical discomfort. 3e. Outcome and Conclusions: The fistula demonstrated complete healing within 3-weeks. The patient reported no complications, and no recurrence was observed during the 6-month follow-up period.