pilonidal sinus and pilonidal cyst
Introduction
Introduction to Tibetan sinus and hair follicles Pilonidalsinus and Pilonidal cysts (Pilonidalsinus and Pilonidalcyst) are collectively referred to as Pilonidal disease (Pilonidaldisese), a chronic sinus or cyst in the soft tissue of the intercondylar rupture of the appendix. It can also be manifested as an acute abscess in the appendix. After piercing, it forms a chronic sinus, or it is temporarily healed, and finally pierced, so it can be repeated. The cyst is accompanied by granulation tissue, fibrous hyperplasia, often containing a tuft of hair. Although the disease can be seen after birth, it usually occurs 20 to 30 years after puberty, and symptoms appear due to increased activity of hair and fat glands. basic knowledge Probability ratio: Susceptible people: no specific population Mode of infection: non-infectious Complications: abscess
Cause
The cause of sinus and hair follicles
Causes of the disease: The real cause is unknown, but the academic world generally has the following two theories.
Congenital (40%):
Due to the stenosis of the medullary canal or the development of the appendix, the inclusions of the skin are involved, but the anterior and posterior fovea of the baby are rarely found in the anterior and posterior fossa of the baby, but it is more common in adults.
Acquired (30%):
It is believed that sinuses and cysts are granulomatous diseases caused by injury, surgery, foreign body stimulation and chronic infection. Recently, it has been confirmed that hair that has entered from outside is the main cause, and that interlabial rupture has a negative attraction effect, which can cause the shed hair to penetrate subcutaneously. The hair inside the crack is too long, the top of the hair has the effect of filtering and soaking the skin. The hair penetrates into the skin to form a short track. Later, the sinus is deepened, and the hair roots fall into the sinus to penetrate the hair shaft. During the process, movement changes can be seen, but only half of the cases can be found. This disease is more common in patients with multiple hairy levels, excessive sebum activity, deep intergluteal edema and often injured hips. The car driver's appendix skin is often subject to long-term bumps and damage. It can cause sebaceous gland tissue and debris to accumulate in the sac, causing inflammation. The US Army has many diseases, called Jeep disease. Common pathogens include anaerobic bacteria, staphylococcus, streptococcus and Escherichia coli, Rainsbury and Southan. The analysis of stationary Tibetan hair disease, less than half of the single bacteria, and anaerobic bacteria accounted for 58%, strangely, staphylococci are not common, most aerobic bacteria are Gram-negative bacteria. The formation and natural evolution of the sinus sinus: Right there is a small nest in the ditch, and the hair gradually penetrates; the hair penetrates more, and the skin sinus is formed due to secondary inflammation.
Prevention
Tibetan sinus and hair follicle prevention
Cancer is rare in the sinus sinus. Phipshen (1981) has only 32 cases of literature review. The lesions are mostly well-differentiated squamous cell carcinoma. The wound changes should cause suspected cancerous changes, such as ulceration, rapid growth, and sedan. For fungal-like margins, extensive resection should be preferred. Because wounds are widely used for treatment with skin grafts or flaps, abdomen lymphadenopathy should be biopsied to exclude metastasis. If there is metastasis, the prognosis is poor. The literature reports a 5-year survival rate of 51. %, the recurrence rate was 50%, and the abdomen lymph node metastasis was found to be 14% at the time of initial diagnosis.
Complication
Complications of sinus and hair follicles Complications
Most manifested as recurrent or frequent water flow to form sinus or fistula, sometimes complications such as abscess and cellulitis.
Symptom
Symptoms of sinus and hair follicles common symptoms sinus purulent secretions, acute abscess cysts, cellulitis
The main diagnostic markers of sinus sinus and sacral hair follicles are acute abscesses in the appendix or chronic sinus that are secreted. Local inflammatory sinus is present. The sinus cavity is seen in the midline. The sinus is easily diagnosed by symptoms and signs. .
The hair follicles are often asymptomatic if there is no secondary infection, but the appendix is protruding. Some feel the pain and swelling of the appendix. The main and initial symptoms are acute abscesses in the appendix. Local redness, swelling, heat, pain, etc. The characteristics of inflammation, multiple automatic breakthrough out of the pus or after the surgical drainage, the inflammation subsided, a small number of drainage can be completely closed, but most of the manifestations of recurrent or frequent water to form a sinus or fistula.
In the quiescent period of the sinus sinus, irregular small holes can be seen in the skin of the midline of the appendix. The diameter is about 1mm~1cm. The surrounding skin is red and swollen and hard. There are often scars, some visible hair, and the probe can be probed into 3~4mm. It can be penetrated into 10cm. It can discharge thin and odorous liquid when squeezed. It has acute inflammation during acute attack, has tenderness and redness, discharges more purulent secretions, and sometimes abscess and cellulitis.
Examine
Examination of sinus and hair follicles
At the time of examination, the cryptic cavity was seen in the midline position, and the sinus sinus was easily diagnosed by symptoms and signs.
Diagnosis
Diagnosis and differentiation of sinus and hair follicles
Should be identified with sputum, anal fistula and granuloma, sputum grows on the skin, protrudes from the skin, the top is yellow, there are multiple external holes in the sputum, there is necrotic tissue inside, the outer mouth of the anal fistula is close to the anus, the fistula is going to the anus, percussion There is a cord, the internal anal canal has an internal mouth, and there is a history of anorectal pus, while the direction of the sinus sinus is multi-directional to the cranial side, rarely down, tuberculous granuloma is connected to the bone, and X-ray examination shows bone. The quality is destructive, tuberculous lesions are found in other parts of the body, syphilitic granuloma has a history of syphilis, and syphilis is seropositive.
