SHATAPONAK BHAGANDARA (FISTULA IN ANO WITH MULTIPLE OPENINGS)

A 55 year old male attended the OPD of Shalya tantra department, S.V.N.H.T Ayurved College, Rahuri (Maharashtra) with the complaints of difficulty in sitting and walking due to severe pain, pus discharge, itching, intermittent bleeding and swelling in perianal region and on and off mild fever. On physical examination multiple external openings were found around the anus. On probing multiple openings were connected internally with external opening located at 60 clock position. Fistulogram was advised. Fistulogram revealed that low anal fistula with multiple openings. Finally patient was diagnosed as Shataponak Bhagandara[1] which correlates with fistula in Ano with multiple openings in modern surgical practice. After surgical profile of the patient; he had been posted for the Ayurvedic minimally invasive procedure i.e., Ksharasutra. Ksharsutra procedure was done under spinal anesthesia and subsequent change of the thread was done on weekly basis for 10 weeks. Brief description about the disease Bhagandara and Kshrasutra preparation and its application is also important.[2] Studies also reported the comparative efficacy of the different kinds of Ksharasutra.[3] Ksharsutra procedure not only prevents further complications of the condition but also cures the condition[4]