sacrococcygeal sinus formation
Introduction
Introduction Pilonidal sinus and Pilonidal cysts are collectively called Pilonidal disese, 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.
Cause
Cause
First, congenital
Inclusion of the skin due to residual medullary canal or developmental malformation of the appendix. However, with the infant's midline anal posterior fovea, few pre-existing lesions of the hairy disease are found, but it is more common in adults.
Second, acquired nature
The sinus and cyst are considered to be granulomatous diseases caused by injury, surgery, foreign body irritation, and chronic infection. It has recently been confirmed that hair that has entered from outside is the main cause. The inter-hip rupture has a negative attraction effect, allowing 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. Changes in movement can be seen, but hair can be found in only half of the cases. This disease is more common in patients with polychaine, excessive sebum activity, excessive intergluteal edema, and often injured hips. Car driver's appendix skin is often subject to long-term upsets and damage, allowing sebaceous gland tissue and debris to accumulate in the sac, causing inflammation.
The US Army has a lot of this disease, called Jeep disease. Common pathogens are anaerobic bacteria, staphylococcus, streptococcus and Escherichia coli. Rainsbury and Southan analyzed static hair damage, with less than half of the individual bacteria and 58% of anaerobic bacteria. The strange thing is that staphylococcus is not common, and most aerobic bacteria are Gram-negative bacteria.
Examine
an examination
Related inspection
Skin smear microscopy skin elasticity check
The hair follicles are often asymptomatic if there is no secondary infection, but the appendix is protruding, and some feel the pain and swelling of the appendix. Usually the main and initial symptoms are acute abscesses in the appendix, localized with acute inflammation such as redness, swelling, heat and pain. Multiple automatic breakout out of the pus or after surgical drainage, the inflammation subsides, a small number of drainage can be completely closed, but most of the manifestations of recurrent or frequent water flow 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, and the diameter is about 1 mm to 1 cm. The surrounding skin is red and swollen and hard, often with scars and visible hair. The probe can be probed into 3~4mm, and some can be probed into 10cm. When squeezed, it can discharge the odorous liquid. Acute exacerbation has acute inflammatory manifestations, tenderness and redness, discharge of more purulent secretions, and sometimes abscesses and cellulitis.
Diagnosis
Differential diagnosis
It should be differentiated from sputum, anal fistula and granuloma. The cockroach grows on the skin, protruding from the skin, and the top is yellow. The sputum has multiple outer holes with necrotic tissue. The outer mouth of the anal fistula is close to the anus, the fistula is lined to the anus, the percussion has a cord, the anal canal has an internal mouth, and there is a history of anorectal pus. The direction of the sinus sinus is multi-directional to the cranial side, rarely downward.
