Pilonidal cyst: Difference between revisions

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


==Diagnosis==
==Clinical Features==
*May present as a painless cyst, acute abscess, or recurring cysts w/ draining sinuses
[[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
*Occurs in midline in the upper part of the natal cleft
**Does not communicate with the anorectum
**Does not communicate with the anorectum
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==Differential Diagnosis==
==Differential Diagnosis==
*Syphilitic and tuberculous granulomas
*Simple furuncles
*Fungal infection
*Sacral osteomyelitis
{{Anorectal DDX}}
{{Anorectal DDX}}


==Treatment==
==Evaluation==
*[[I&D]]
*Clinical
 
==Management==
*[[I&D]] - longitudinal incision lateral to sacral midline
*[[Antibiotics]] only needed if [[cellulitis]] is present
*[[Antibiotics]] only needed if [[cellulitis]] is present
*Refer to surgeon for recurrent disease
*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]]


==Source==
==References==
Tintinalli
<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

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

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

  1. Rosen's 7th Ed