Pilonidal cyst: Difference between revisions
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==Background== | ==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== | |||
[[File:Pilonidal abscess.jpg|thumb|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== | ==Differential Diagnosis== | ||
{{Anorectal DDX}} | {{Anorectal DDX}} | ||
== | ==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)<ref>Rosen's 7th Ed</ref> | |||
==See Also== | ==See Also== | ||
*[[Anorectal Disorders]] | *[[Anorectal Disorders]] | ||
== | ==References== | ||
<references/> | |||
[[Category:GI]] | [[Category:GI]] | ||
[[Category:Dermatology]] | |||
Latest revision as of 17:27, 10 September 2020
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
- 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
- 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
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]
See Also
References
- ↑ Rosen's 7th Ed