Apamarga Ksharasutra application in blind external Fistula-in-Ano in a paediatric patient : A Case Report

Abstract

This case study details the management of a blind fistula-in-ano in a paediatric patient using Kshar Sutra therapy. The 10-year-old male presented with severe perianal pain exacerbated by defecation and prolonged sitting. Despite being malnourished and underweight, systemic examinations were found normal. Diagnostic findings revealed perianal induration and a sinus tract extending to the dentate line at the 11 o'clock position. Surgical intervention involved a stab incision, excision of unhealthy tissue, and Apamarga Ksharsutra ligation at 11 to 11 o'clock position (external to internal). Post-operative care included sitz baths with Panchavalkala Kwatha, topical applications Panchavalkala Malhara, and orally Kanchnar guggulu 1 tab tds after meal with luke warm water. The patient showed progressive healing without complications like incontinence or recurrence during follow-up of 4 months, demonstrating the efficacy and safety of Ksharsutra therapy in managing complex fistula -in-ano cases in paediatric patients.