Management of Multiple Fistula–in–Ano with Sadyaksharasutra- A Case Report

Abstract

Fistula-in-ano is a track lined by granulation tissue with two openings one in the anal canal or rectum and the other on the skin around anus. The disease is challenging because of its recurring nature and complications. Fistula may also present with multiple tracts when associated with other diseases like TB, actinomycosis etc. or if left untreated for a long period of time. Here is a case of multiple fistula-in-ano diagnosed with MRI fistulogram.  A 37year old male patient had presented with six patent fistulous tracts in the perianal region along with pain and pus discharge. Due to the multiplicity of tract and thereby chances of prolongation of its treatment period, the management was planned with a newer technique. This case is discussed here to introduce this new technique to promote quicker cutting and healing and it is the ‘Sadyaksharasutra’. Here all of the six tracts were cut opened by the sadyaksharasutra within two weeks and complete healing was attained in next six weeks ie., the whole treatment period was shortened to two months, with no complications. With the usage of sadyaksharasutra in the present case, the cutting and healing of the fistulous tracts was made faster and the whole treatment period was shortened.