Author(s): Manoj Bhadja, Tukaram Dudhamal, Sanjay Kumar Gupta

Abstract: In Ayurveda practice Ksharasootra (a para-surgical procedure) is widely popular in the management of anorectal disorders specifically in fistula-in-ano. It is also tried in the simple cases of piles and found effective. In this case report a 45 years old male patient visited to outpatient department of Ayurved research hospital with complaints of severe pain, bleeding and prolapsed something at anal region. After local examination the case was diagnosed as forth grade inflamed interno-external hemorrhoids at 3, 7 and 11 O’clock position. The case was admitted in the hospital and Ksharasootratransfixion and ligation was done under spinal anesthesia. The ligated pile masses were sloughed out on sixth postoperative day and the patient was relieved from all symptoms within 15 days. No complications were reported after the procedure. The patient was followed up regularly from April 2015 onward till date and did not reveal any postoperative complication and evidence of recurrence of piles. Hence this case highlighted that complicated fourth grade piles can be managed with ligation of Ksharasootra.