Pilonidal sinus Flashcards

1
Q

define a pilonidal sinus?

A

an abnormal epithelium-lined tract filled with hair that opens onto the skin surface, most commonly in the natal cleft

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2
Q

what are the risk factors of a pilonidal sinus?

A
  • Caused by shed or sheared hairs penetrating the skin and inciting and inflammatory reaction and sinus development
  • Intermittent negative pressure will draw in more hair and perpetuate the cycle
  • Eventually an abscess forms
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3
Q

risk factors of pilonidal sinuses?

A

o Hirsutism
o Spending a long time sitting down
o Occupational e.g. hairdressers may develop interdigital pilonidal sinus)

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4
Q

epidemiology of pilonidal sinus?

A
  • Affects 0.7% of young adults
  • More common in men after puberty
  • More common in Caucasians
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5
Q

presenting symptoms of pilonidal sinuses?

A
  • Painful natal cleft
  • Discharging swelling
  • Can present with an abscess
  • Cycles of being asymptomatic and periods of pain and discharge
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6
Q

signs of pilonidal sinus on physical examination?

A
  • Midline openings or pits between the buttocks
  • Hairs may protrude from the swelling
  • If infection or abscess, the swelling will become tender
  • It may be fluctuant and discharge pus or blood-stained fluid on compression
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7
Q

investigations for pilonidal sinuses?

A

• NONE needed
• Bloods - to check for signs of infection
o Raised WCC
o Fasting glucose (diabetics are at risk)

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8
Q

management for abscess?

A

o antibiotics Incision and drainage

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9
Q

management for pilonidal sinuses?

A

• Bascom procedure
o Excision of pits and destruction of the underlying cavity.
• Karydakis procedure
o Involves wide excision of the natal cleft

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10
Q

how to prevent pilonidal sinuses?

A

o Good hygiene

o Shaving

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11
Q

complications of pilonidal sinuses?

A
  • Pain
  • Infection
  • Abscess
  • Recurrence
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12
Q

what is the prognosis for patients with a pilonidal sinus?

A
  • Good with drainage
  • Shaving will cure in most cases
  • Usually resolves by the age of 40
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