Successful non operative treatment of high rectal fistula

Abstract

The present paper deals with a study of 50 cases having a high internal opening or an abscess cavity above the levator ani muscle. These cases of high rectal fistula invariably end up with complications after surgery in the form of injuries to the anal sphincters leading to incontinence. The term 'high rectal' denotes the types of fistulae having exceptionally long tracts and includes the 'high anal' and 'ano rectal' varieties according to Milligan Morgan's classification. The technique of treatment used involves ligating the entire fistulous tract with a caustic ligature without performing an excisional therapy. This ligature is prepared by repeatedly smearing a size 20 surgical thread with certain vegetable caustics as described in the ancient Indian literature and several times reported by us previously. The insertion of the thread into the fistulous tract can be achieved without much difficulty with the help of specially designed instruments. This treatment has been tried in 50 cases of high rectal fistula with exceedingly good results.