Pilonidal cyst
Revisión del 20:20 8 jul 2016 de Rossdonaldson1 (discusión | contribs.) (Text replacement - "infx" to "infection")
Background
- Sinus is formed by penetration of skin by ingrowing hair
- Leads to foreign body granuloma reaction, sinus perpetuated by repeated bouts of infectionn
- 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
Diagnosis
- 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