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Case Report

Online Publishing Date:
11 / 12 / 2018

 


Integrative Management of Trans-sphincteric-Anal-Fistula, Fissure-in-Ano and Internal-Piles in single sitting: A Case Study.

Dr Foram Joshi.


Abstract
INTRODUCTION: Simultaneous occurrence of piles fissure and fistula is not uncommon. But it is quiet difficult to achieve complete relief in all three entity by intervening them in a single sitting. CASE REPORT: A 41 year male presented to our Shalyatantra OPD with 3 months history of a recurrent boil and pus discharge from peri-anal area, protrusion of mass per anus which was self reducible in nature and feeling of mass-like structure per anus during and after defecation. On examinations, he was diagnosed as a case of trans-sphicteric low anal fistula in ano with 3, 7 and 11 o’clock 2nd degree internal piles and 6 o’clock sentinel tag. He was treated with planned partial fistulectomy and Ksharasootra threading in fistula, classical excision of sentinel tag and Ksharasootra ligation in piles under spinal anaesthesia. RESULT AND DISCUSSION: Complete cut-through of fistula (28 days), post-fissurectomy wound healing (15 days), sloughing out of legated pile masses (7 days) and post Ksharasootra threading fistula wound healing (48 days). Unit cutting time of fistula was observed 6.66 days/cm. Since then he has been found without recurrence till date (>12 months). CONCLUSION: Integrative management has potential role in managing all the three anal pathologies together.

Key words: Fistula, fissure, piles, integrative management, Ksharasootra


 
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Pubmed Style

Dr Foram Joshi. Integrative Management of Trans-sphincteric-Anal-Fistula, Fissure-in-Ano and Internal-Piles in single sitting: A Case Study.. J Res Educ Indian Med . Online First: 11 Dec, 2018. doi:10.5455/JREIM.82-1517473551

Web Style

Dr Foram Joshi. Integrative Management of Trans-sphincteric-Anal-Fistula, Fissure-in-Ano and Internal-Piles in single sitting: A Case Study.. https://www.jreim-ayushjournal.com/?mno=289908 [Access: March 10, 2024]. doi:10.5455/JREIM.82-1517473551

AMA (American Medical Association) Style

Dr Foram Joshi. Integrative Management of Trans-sphincteric-Anal-Fistula, Fissure-in-Ano and Internal-Piles in single sitting: A Case Study.. J Res Educ Indian Med . Online First: 11 Dec, 2018. doi:10.5455/JREIM.82-1517473551


Vancouver/ICMJE Style

Dr Foram Joshi. Integrative Management of Trans-sphincteric-Anal-Fistula, Fissure-in-Ano and Internal-Piles in single sitting: A Case Study.. J Res Educ Indian Med , [cited March 10, 2024]; Online First: 11 Dec, 2018. doi:10.5455/JREIM.82-1517473551


Harvard Style

Dr Foram Joshi (0) Integrative Management of Trans-sphincteric-Anal-Fistula, Fissure-in-Ano and Internal-Piles in single sitting: A Case Study.. J Res Educ Indian Med , Online First: 11 Dec, 2018. doi:10.5455/JREIM.82-1517473551


Turabian Style

Dr Foram Joshi. 0. Integrative Management of Trans-sphincteric-Anal-Fistula, Fissure-in-Ano and Internal-Piles in single sitting: A Case Study.. Journal of Research and Education in Indian Medicine, Online First: 11 Dec, 2018. doi:10.5455/JREIM.82-1517473551


Chicago Style

Dr Foram Joshi. "Integrative Management of Trans-sphincteric-Anal-Fistula, Fissure-in-Ano and Internal-Piles in single sitting: A Case Study.." Journal of Research and Education in Indian Medicine Online First: 11 Dec, 2018. doi:10.5455/JREIM.82-1517473551


MLA (The Modern Language Association) Style

Dr Foram Joshi. "Integrative Management of Trans-sphincteric-Anal-Fistula, Fissure-in-Ano and Internal-Piles in single sitting: A Case Study.." Journal of Research and Education in Indian Medicine Online First: 11 Dec, 2018. Web. 10 Mar 2024 doi:10.5455/JREIM.82-1517473551


APA (American Psychological Association) Style

Dr Foram Joshi (0) Integrative Management of Trans-sphincteric-Anal-Fistula, Fissure-in-Ano and Internal-Piles in single sitting: A Case Study.. Journal of Research and Education in Indian Medicine, Online First: 11 Dec, 2018. doi:10.5455/JREIM.82-1517473551


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