Pilonidal cyst: Difference between revisions
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==Treatment== | ==Treatment== | ||
*[[I&D]] | *[[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== | ||
Revision as of 00:10, 12 December 2015
Background
- Sinus is formed by penetration of skin by ingrowing hair
- Leads to foreign body granuloma reaction, sinus perpetuated by repeated bouts of infxn
- Carcinoma is rare complication of chronic, recurring pilonidal sinus disease
Diagnosis
- 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
- Because of proximity to anus can be confused for a perianal abscess
Differential Diagnosis
- Syphilitic and tuberculous granulomas
- Simple furuncles
- Fungal infection
- Sacral osteomyelitis
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
Treatment
- 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
Source
Tintinalli
- ↑ Rosen's 7th Ed