Case #3

Student details , SANTU SAHA , 
IQCMC , Durgapur , India
Class - General Medicine ward ( 4th semester )

Age : 21 Years 4 Months
Sex : Male
Occupation : College student
State : Assam
Year : 2017

Chief complains

1. Swelling in the anal triangle of Perineum
2. Intense pain
3. Difficulties in performing daily like walking , standing , sitting
due to the pain

History of present illness

Regarding the Pain
1. Onset : 4-5 days ago , the pain became intense
2. Position : above anus , in the anal triangle
3. Quality : continous pain
4. Relieving or Aggravating factor : relieve from pain in
Lithotomy position while the pain aggravated while standing
and walking
5. Severity : intolerable
6. Timing : no specific time
7. Treatment : minor operation

History of past illness
1. Infrequent constipation for last 1 years
2. Minor trauma in an accident 2 years ago
Family history

1. Uncle and a close cousin

Clinical diagnosis

# It has been found that the patient is having , Fistula in Ano.
# Histopathology report of the specimen extracted (Fistulous
tract in the perianal area) suggest that it is a Chronic Non-
specific inflammatory lesion.

Findings and Suggestions

# Injection of radio-opaque fluids like Lipodol , into a sinus or a fistula ( i.e. sinogram or fistulogram ) will indicate the cause of the sinus or fistula by delineating its course.
# Fistula-in-ano is often seen in more than one member in a family.
# If there were any history of Colloid carcinoma of rectum , then it may have produced anal fistula in later stage.
# Traumatic fistula like faecal fistula , may occur after operation or after accidental injury to certain.

And finally , Thanks a lot , to the patient for giving his valuable time and long time co-operation !