Pilonidal sinus and cyst: a comparative evaluation of various surgical methods in 229 consecutive cases.
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Cysts↗
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Pilonidal sinus and cysts (sacro-coccygeal sinus); report of 22 cases treated by excision and primary suture.
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Cysts↗
Pilonidal sinus of the glans penis associated with actinomyces case reports and review of literature.
Pilonidal sinus is a well-recognized condition that occurs most commonly in the sacrococcygeal area of younger men. It is hypothesized to be an acquired chronic inflammation condition due mainly to hair trapped beneath the surface. A pilonidal sinus in the sacrococcygeal region is associated with recurrent infection, abscess formation, cellulitis, fistulae, and rarely, squamous cell carcinoma. A pilonidal sinus of the penis is a rare entity. The association of a penile pilonidal cyst and Actinomyces is even more uncommon with only three cases reported previously. Two cases of pilonidal sinus are reported in this paper. One of the cases was associated with actinomycosis. Pilonidal sinus of the penis should be considered in the clinical and pathological differential diagnosis and has to be distinguished from balanoposthitis, epidermal cyst, and carcinoma. The knowledge about possible association with actinomycosis is important to ensure early treatment.
Actinomyces↗
Retrorectal cyst: a rare tumor frequently misdiagnosed.
BACKGROUND: The rarity of retrorectal cysts and their nonspecific clinical presentations often lead to misdiagnoses and inappropriate operations. In recent years, several such patients have been referred to our institutions for evaluation and treatment of misdiagnosed retrorectal cysts. A review of these patients is presented. STUDY DESIGN: Medical records of the colorectal surgery divisions at two institutions were reviewed. Patients found to have previously misdiagnosed retrorectal cysts were identified. Preliminary diagnoses, radiologic examinations, operative procedures, and final diagnoses were obtained. RESULTS: Seven patients with retrorectal cysts who had been misdiagnosed before referral were identified. These patients had been treated for fistulae in ano, pilonidal cysts, perianal abscesses; psychogenic, lower back, posttraumatic, or postpartum pain, and proctalgia fugax before the correct diagnosis was made. Patients underwent an average of 4.1 operative procedures. Physical examination in combination with CT scanning made the correct diagnosis in all patients. All patients underwent successful resection through a parasacrococcygeal approach, and six of seven did not require coccygectomy. The resected tumors included four hamartomas, two epidermoid cysts, and one enteric duplication cyst. CONCLUSIONS: Retrorectal cysts are a rare entity that can be difficult to diagnose without a high index of clinical suspicion. A history of multiple unsuccessful procedures should alert the clinician to the diagnosis of retrorectal cyst. Once suspected, the correct diagnosis can be made with physical examination and a CT scan before a definitive surgical procedure.
Abscess↗
Squamous-cell carcinoma of the pilonidal sinus: report of a case and review of the literature.
Squamous-cell cancer developing in chronic pilonidal sinuses is extremely rare. Thousands of pilonidal cysts and sinuses are operated upon each year, and malignancy is almost never encountered. Only 26 cases of malignancy arising in pilonidal sinuses are reported in the world literature. We report and document a squamous-cell cancer arising in a chronic pilonidal sinus and also review the world literature.
Adolescent↗
[Treatment of pilonidal disease using an LLL-plasty technic. Apropos of 27 cases].
The authors report 42 cases of pilonidal cyst on which 27 have been operated with the L-shaped skin graft "LLL-plasty". This technic has been applied to large pilonidal lesions, half of which were failures of other methods. Though the excision was large, the suture was easily practised with this technic. The healing time is around 13 days. The rate of relapse is small, but could be improved with more rigor in the indication and with constant medical supervision of the patients, imposing strict hygienic rules.
Cicatrix↗
[Verneuil's disease in the differential diagnosis of suppuration of the ano-perineo-buttock region].
Verneuil's disease or hidradenitis suppurativa is not frequent. Nevertheless since VERNEUIL's classic description in 1854, many cases have been reported. It is a disease of the apocrine sweat glands, that may arise on each of their localizations: axilla, breast areolae, umbilicus, perineum, groin, buttocks. The chronic suppurative disease of these glands give rise to multiple fistulous constantly infected tracts. The typical appearance usually allows a clinical diagnosis. Other disease may nevertheless look like hidradenitis suppurativa. We present two cases and discuss the differential diagnosis between the hidradenitis suppurativa and the chronic infection of a pilonidal cyst.
Buttocks↗
Fine-needle aspiration cytology of metastatic squamous-cell carcinoma arising in a pilonidal sinus, with literature review.
Fewer than 50 cases of carcinoma arising in a pilonidal sinus have been reported, with only 5 patients having documented inguinal lymph node metastases. This is the first report of the fine-needle aspiration (FNA) diagnosis of this uncommon clinical situation of squamous-cell carcinoma arising in a pilonidal sinus, metastatic to an inguinal lymph node. We report on a 59-yr-old male with squamous-cell carcinoma arising in a pilonidal sinus who presented with inguinal adenopathy. FNA biopsy of a lymph node was performed, resulting in a diagnosis of metastatic squamous-cell carcinoma. FNA biopsy is useful in the evaluation of patients with inguinal adenopathy and a history of malignancy arising in a pilonidal sinus. The possibility of this rare complication should also be considered when metastatic squamous-cell carcinoma to an inguinal lymph node is diagnosed by FNA cytology in patients having an unknown primary except for a change in a long-standing pilonidal cyst.
Biopsy, Needle↗
Toxic shock syndrome after pilonidal cystectomy. Report of a case.
Toxic shock syndrome is an uncommon disease associated with staphylococcal infections. Although most frequently reported in menstruating women and associated with tampon use, toxic shock syndrome has been described following many types of surgical procedures. In this report we describe a case of toxic shock syndrome occurring in a previously healthy young man after elective surgery for a pilonidal cyst.
Adult↗
Pilonidal sinus with an anal canal fistula. Report of a case.
A rare case of a pilonidal cyst with the fistulous tract situated inside the anal canal is described. This is the sixth such case in the medical literature.
Adult↗
[Treatment of pilonidal sinus. Our experience].
The various types of surgical techniques adopted in a group of 167 patients suffering from pilonidal cysts and fistulas are examined: closed, semi-closed and open method. The results are assessed and the reasons for preferring the closed method are examined.
Adolescent↗
[Sacrococcygeal teratoma in adults].
This report describes a case of sacrococcygeal teratoma, a rare pathology belonging to the group of presacral tumors. Its clinical presentation is very variable. In this case, the tumor presented as a pilonidal cyst, which is an atypical form. The teratoma was associated with a spinal malformation, described in 25% of all cases. It was treated by "en bloc" resection with sacrectomy.
Adult↗
[A note on surgical technics. The treatment of pilonidal disease in the chronic phase. Our methodology].
The authors propose a method of suturing the wound caused by the removal of pilonidal cysts and fistulas. The technique is noninvasive, uses a minimum amount of foreign material, and places the margins of the wound under very slight tension.
Adolescent↗
Mature presacral teratoma in an adult male: a case report.
Presacral teratomas are rare tumors derived from more than one embryonic germ layer and are usually diagnosed in infancy. It has been estimated that the incidence of presacral teratoma in children ranges from 1 in 30,000 to 1 in 43,000 live births. However, the diagnosis of these tumors in adults is extremely rare. H. Head et al. reviewed the world literature in 1975 and found only 71 reported cases. Since that time, an additional 14 cases have been reported, and only one of these was found in the United States. This study reports a case of an adult male who presented with recurrent infected pilonidal cysts that proved to be benign presacral teratoma at biopsy. The patient underwent resection by left hemisacrectomy and primary closure using a posterior approach and, since this procedure, has had no evidence of recurrence. The case is presented along with a review of the relevant literature.
Adult↗
Outpatient anorectal surgery.
Fulguration of polyps, rectal biopsy and the Barron method of removing hemorrhoids require no anesthesia. Anal fissures, warts, small fistulas and hemorrhoids can be removed with a minimal amount of anesthesia. Pilonidal cysts or abscesses can also be incised and drained in this manner. Extensive fistulas, unusually large hemorrhoids with generalized prolapse of mucosa and disorders involving poor-risk patients should be managed in the hospital.
Abscess↗
Primary closure of pilonidal cystectomy.
A method of primary closure following excision of pilonidal cysts and sinus was used in 38 cases. The criteria for patient selection are described as is the technique and procedure. Special attention must be placed on the obliteration of all "dead spaces" to eliminate accumulation of serum and blood. The dressing is not changed for a minimum of eight days, and pressure must be maintained for that time to assure success. In all cases complete closure was obtained. The advantages of this technique over the open procedure is explained.
Dermatologic Surgical Procedures↗
Infrared and Raman microspectroscopy of foreign materials in tissue specimens.
Infrared and Raman spectra of materials found in tissue specimens submitted for histopathologic diagnosis have been recorded. These foreign materials range in size from approximately 5 to 50 microm, and the vibrational spectra have been used to identify them. Examples include cholesterol and polytetrafluoroethylene (PTFE) in an implant case, polyethylene terephthalate (PET) and polyacrylonitrile (PAN) in a pilonidal cyst, and carbenicillin in a skin biopsy. In some instances, either the infrared or Raman spectra were sufficient to make a definitive identification, while in other cases both were necessary. Because some of the samples fluoresced with visible excitation at 532 nm, FT-Raman spectra with 1064-nm excitation were also recorded. The flexibility of sampling for vibrational microspectroscopy and the value of the recorded data in assisting pathologists render medical diagnoses in the examples cited and other cases are discussed.
Acrylic Resins↗
[Grafts for surgery of the anus (author's transl)].
In surgery of the anus, grafts should be used as a complement to the extensive resections of lesions such as: skin tumors, radiotherapic lesions, resistant itching, chronic infection, pilonidal cysts, multiple fistulae. Such grafts are useful in many instances because they shorten the period of healing and insure a better skin cover. Grafts used in anal surgery are: the Davis-patch type, the free skin type and the pedicle-flap type. Each has its own indications. They are immediate or delayed. The author's experience indicates that indications for grafts are frequent, that their effects are always favorable and that the rate of failure is very low despite the risk of contamination from the proximity with the anus.
Anal Canal↗