PERSPECTIVE OF BHAGANDAR AS A MAHAGADA BY A CASE REPORT REVIEW OF CHRONIC FISTULA IN ANO DEVELOPING INTO MUCINOUS ADENOCARCINOMA.

Abstract

Bhagandar (Fistula in Ano) is a common clinical condition in perineal area which is considered as Mahagada by Acharya Sushruta due to the difficulties in the treatment, in curability, recurrence and development of complications. The conceptual study shows belief of different acharyas regarding the concept of Mahagada which aid to decide prognosis of diseases. So there is need for interpretation and appropriate clinical understanding of the Mahagada for better clinical out come in Bhagandar. Mucinous adenocarcinoma of the perianal region is an oncologic rarity posing a diagnostic and the rapeutic dilemma for treating oncologists due to very few reported cases without definite therapeutic guidelines. It accounts for 2% to 3% of all gastro intestinal malignancies and are historically known to arise from chronic anal fistulas and ischiorectal or perianal abscesses. An effort is made to support the concept of Mahagada through reporting a rare case of perianal mucinous adenocarcinoma in a 63-year-old male in itially treated with surgical intervention twice for recurrent fistula in ano and procedures like Ksharasutra (medicated Seton thread) for 6-8 months duration.