Pilonidal cyst: Difference between revisions

Latest revision as of 23:52, 4 January 2026

Background

Sinus is formed by penetration of skin by ingrowing hair
- Leads to foreign body granuloma reaction, sinus perpetuated by repeated bouts of infection
Carcinoma is rare complication of chronic, recurring pilonidal sinus disease

Clinical Features

Pilonidal abscess of buttox.

May present as a painless cyst, acute abscess, or recurring cysts with draining sinuses
Occurs in midline in the upper part of the natal cleft
- Does not communicate with the anorectum
- Because of proximity to anus can be confused for a perianal abscess

Differential Diagnosis

Anorectal Disorders

Anal fissure
Anal fistula
Anal malignancy
Anal tags
Anorectal abscess
Coccydynia
Colorectal malignancy
Condyloma acuminata
Constipation
Crohn's disease
Cryptitis
GC/Chlamydia
Fecal impaction
Hemorrhoids
- Internal hemorrhoid
- External hemorrhoid
Levator ani syndrome
Pedunculated polyp
Pilonidal cyst
Proctalgia fugax
Proctitis
Pruritus ani
- Enterobius (pinworms)
Rectal foreign body
Rectal prolapse
Syphilitic fissure

Non-GI Look-a-Likes

Prostatitis

Evaluation

Clinical

Management

I&D - longitudinal incision lateral to sacral midline
Antibiotics only needed if cellulitis is present
Refer to surgeon for recurrent disease
- 40% recurrence rate
- Refer for follicle removal after acute inflammation subsides (~1 wk)^[1]

References

↑ Rosen's 7th Ed

Authors:

[1] Rosen's 7th Ed

[1]

@@ Line 1: / Line 1: @@
+<languages/>
+<translate>
 ==Background==
-#Sinus is formed by penetration of skin by ingrowing hair
-##Leads to foreign body granuloma reaction, sinus perpetuated by repeated bouts of infxn
+*Sinus is formed by penetration of skin by ingrowing hair
-#Carcinoma is rare complication of chronic, recurring pilonidal sinus disease
+**Leads to foreign body granuloma reaction, sinus perpetuated by repeated bouts of infection
-==Diagnosis==
+*Carcinoma is rare complication of chronic, recurring pilonidal sinus disease
-#May present as a painless cyst, acute abscess, or recurring cysts w/ draining sinuses
-#Occurs in midline in the upper part of the natal cleft
-##Does not communicate with the anorectum
+==Clinical Features==
-##Because of proximity to anus can be confused for a perianal abscess
-==DDX==
+[[File:Pilonidal abscess.jpg|thumb|Pilonidal abscess of buttox.]]
-#Anal fistula
+*May present as a painless cyst, acute [[Special:MyLanguage/abscess|abscess]], or recurring cysts with draining sinuses
-#Syphilitic and tuberculous granulomas
+*Occurs in midline in the upper part of the natal cleft
-#Simple furuncles
+**Does not communicate with the anorectum
-#Fungal infection
+**Because of proximity to anus can be confused for a perianal abscess
-#Sacral osteomyelitis
-==Treatment==
-#I&D
+==Differential Diagnosis==
-#Abx only needed if cellulitis is present
-#Refer to surgeon for recurrent disease
+</translate>
+{{Anorectal DDX}}
+<translate>
+==Evaluation==
+*Clinical
+==Management==
+*[[Special:MyLanguage/I&D|I&D]] - longitudinal incision lateral to sacral midline
+*[[Special:MyLanguage/Antibiotics|Antibiotics]] only needed if [[Special:MyLanguage/cellulitis|cellulitis]] is present
+*Refer to surgeon for recurrent disease
+**40% recurrence rate
+**Refer for follicle removal after acute inflammation subsides (~1 wk)<ref>Rosen's 7th Ed</ref>
 ==See Also==
-*[[Anorectal Disorders]]
-==Source==
+*[[Special:MyLanguage/Anorectal Disorders|Anorectal Disorders]]
-Tintinalli
+==References==
+<references/>
 [[Category:GI]]
+[[Category:Dermatology]]
+</translate>