Posterior High Anal Fistula can mimic Pilonidal Sinus - A Case Report

Abstract

Acharya Sushruta – Very aptly considered as 'Father of Surgery’, - Authored Sushruta Samhita, which is the main source of knowledge about surgery. He has mentioned Bhagandara, as Ashta-Mahagada (Eight grave disorders) which essentially means difficult to treat. The ultimate goal of Fistula surgery is to eradicate it without disturbing or disturbing minimally the anal sphincter mechanism. To achieve the objective in high anal Fistula, different surgical techniques have been described in literature from time to time. There is no single established way of treating these high anal fistulas. Conventional laying-open technique in high perianal fistula may involve sacrifice of part or whole of the sphincter muscle impairing continence. So, these surgical techniques proved fruitless due to high reoccurrence and post-operative complications. Here we are reporting a case whose MRI fistulogram findings suggestive of Pilonidal sinus /Abscess in right paramedian location in right gluteal region. But on table during surgery case got diagnosed differently that, it was totally Right high anal fistula giving ramifications on both buttocks. The case is detailed as below.