scholarly journals Intermammary pilonidal sinus: rare location of a common condition

2020 ◽  
Vol 8 (1) ◽  
pp. 385
Author(s):  
Gayatri A. Deshpande ◽  
Raj N. Gajbhiye ◽  
Bhupesh Tirpude ◽  
Hemant Bhanarkar ◽  
Vikrant Akulwar ◽  
...  

Pilonidal sinus in the intermammary region is a rare location of an inflammatory condition commonly occurring in the natal cleft. It is typically characterised by a pus and hair containing cavity in the skin lined by granulation tissue connecting the skin surface. A 22 year-old female presented with chronically discharging sinuses in the intermammary region with recurrent abscess formation for one year duration. Although a rare location, clinical diagnosis of pilonidal sinus was made. Complete excision of sinus tract with abscess cavity with primary closure was performed under general anaesthesia. Histopathological examination confirmed pilonidal sinus. On follow up, the scar was healthy with no keloid formation. Pilonidal sinus may rarely occur in intermammary region. Complete excision and primary closure is the mainstay treatment.

2018 ◽  
Vol 119 (2-3) ◽  
pp. 107-112
Author(s):  
Mahmud Saedon ◽  
Andrew Chin ◽  
Maryam Alfa-Wali ◽  
Chun Kheng Khoo ◽  
Aarti Varma

The aim of this study was to compare the filling of the pilonidal sinus tract with fibrin sealant (FS) against tract excision and primary closure (PC) as the primary procedure. Details of all patients who underwent treatment for a symptomatic first episode of pilonidal sinus disease between January 2011 and December 2015 were prospectively recorded in a custom database. Patients underwent PC (n=17) or FS (n=17) according to patient preference. Prior surgical treatment and ongoing infection precluded entry. Patients were treated with antibiotics if presenting with infection. Outcomes measured were recurrence, further procedures, outpatient attendances and length of follow-up to resolution. 34 consecutive patients [FS vs. PC: male n=15 vs. 12 p=0.398; mean age 29 (SEM 12) vs. 30 (SEM 15) p=0.849] were included. Treated preoperative infections were similar FS (n=5) vs. PC (n=12) (p=0.038, chi-squared test). FS cohort had more sinuses FS median (range) 2 (1–4) vs. PC 1 (1–3) (p=0.046). Postoperative outcomes: recurrence rate FS (n=5) vs. PC (n=4) (p=0.629); infection rate FS (n=1) vs. PC (n=8) (p=0.045); total number of operations required FS 1 (1–2) vs. PC 1 (1–4) (p=0.19); total number of outpatient attendance FS 2 (1–7) vs. PC 3 (1–16) (p=0.629); follow-up FS 129 days ± 33 vs. PC 136 ± 51 (p=0.914). Fibrin sealant is not inferior to excision followed by primary closure.


Author(s):  
Firamir Bin Zulkifli ◽  
Farah Dayana Bintin Zahedi ◽  
Ahmad Bin Nordin ◽  
Yong Doh Jeing

<p>Pilonidal sinus is widely associated with disease involving the gluteal cleft. Derived from the Latin word (Pilus=hair; nidus=nest), it was first described by Herbert Mayo in 1833. The pathognomonic finding of the pilonidal sinus is the presence of loose hairs in the sinus tract or cavity. We report a case of a fit middle age policeman who developed an unusual chronic discharging sinus over the tip of the nose. A computed tomography (CT) sinogram showed a localized blind subcutaneous tract over the nose. The course of management is discussed with reference to other reported works of literature. The patient was diagnosed to have a subcutaneous sinus over the tip of the nose with the aid of CT sinogram. Surgery was performed to excised the sinus tract through external rhinoplasty approached. Histopathological examination confirmed a sinus tract lined by keratinized stratified squamous epithelium with a tuft of hair. Patient was follow up for another year with no evidence of recurrence.</p>


Author(s):  
Pradeep Rajbhandari ◽  
Bijaya Kumar Shrestha ◽  
Roshani Shrestha

<p class="abstract">Taenia solium completes its life cycle in two hosts. Generally, cysticercosis results from accidental ingestion of the eggs of taenia solium through faeco‐oral contamination or autoinfection cysticercosis is commonly found in muscular and subcutaneous tissues. Central nervous system and eye are commonly affected. Despite abundant intermuscular tissue in oral cavity, it is uncommon site for cysticercosis because of high muscular activity and metabolic rate of oral tissues. We present a case of a 21-year-old male, presented with painless solitary swelling in the ventral aspect of tip of tongue at the centre. Excision of the swelling was done followed by histopathological examination. The histopathological examination revealed cysticercosis cellulosae in tongue musculature. Histopathological picture showed cysticercus larva surrounded by a double layered membrane. The patient was given albendazole 200 mg TDS for 30 days. One-year follow-up showed no signs of recurrence. Lingual cysticercosis usually presents as diagnostic dilemma. Complete excision along with histopathological examination is diagnostic. Infestation in this region is relatively mild as compared to ocular or neurocysticercosis. However, the patients should be examined thoroughly and followed up for possible concurrent ophthalmologic and neurologic involvements as well.  </p>


Swiss Surgery ◽  
2002 ◽  
Vol 8 (6) ◽  
pp. 255-258 ◽  
Author(s):  
Perruchoud ◽  
Vuilleumier ◽  
Givel

Aims: The purpose of this study was to evaluate excision and open granulation versus excision and primary closure as treatments for pilonidal sinus. Subjects and methods: We evaluated a group of 141 patients operated on for a pilonidal sinus between 1991 and 1995. Ninety patients were treated by excision and open granulation, 34 patients by excision and primary closure and 17 patients by incision and drainage, as a unique treatment of an infected pilonidal sinus. Results: The first group, receiving treatment of excision and open granulation, experienced the following outcomes: average length of hospital stay, four days; average healing time; 72 days; average number of post-operative ambulatory visits, 40; average off-work delay, 38 days; and average follow-up time, 43 months. There were five recurrences (6%) in this group during the follow-up period. For the second group treated by excision and primary closure, the corresponding outcome measurements were as follows: average length of hospital stay, four days; average healing time, 23 days; primary healing failure rate, 9%; average number of post-operative ambulatory visits, 6; average off-work delay, 21 days. The average follow-up time was 34 months, and two recurrences (6%) were observed during the follow-up period. In the third group, seventeen patients benefited from an incision and drainage as unique treatment. The mean follow-up was 37 months. Five recurrences (29%) were noticed, requiring a new operation in all the cases. Discussion and conclusion: This series of 141 patients is too limited to permit final conclusions to be drawn concerning significant advantages of one form of treatment compared to the other. Nevertheless, primary closure offers the advantages of quicker healing time, fewer post-operative visits and shorter time off work. When a primary closure can be carried out, it should be routinely considered for socio-economical and comfort reasons.


Author(s):  
Emre Emekli ◽  
Elif Gündoğdu

Background: Lipomas are benign fatty tumors made of fat tissue. Bladder lipomas are extremely rare. For this reason, it is necessary to be aware of the imaging features when incidentally detected in imaging. Case Report: In the abdominal computed tomography (CT) performed as part of the follow-up examination of a 43-year-old patient, who had undergone surgery for adrenal adenoma five years earlier, a 14x9x8 mm smoothly marginated, ovoid-shaped, hypodense mass lesion with a homogeneous internal structure was detected in the anterior bladder wall. The pre-contrast density of the lesion was measured as -105 HU. The magnetic resonance imaging performed one year after the CT examination revealed a 14x9x8 intramural mass in the bladder wall, showing protrusion toward the lumen. The group was observed to be markedly hypointense on fat-suppressed T1 and T2-weighted images and considered consistent with a bladder lipoma. Discussion: Bladder lipomas are benign lesions that can vary in clinical presentations but usually cause hematuria. The differential diagnosis of bladder lipomas includes other mesenchymal rare benign tumors that can arise from the urinary bladder submucosal layer, including leiomyoma, hemangioma, plasmacytoma, fibroma, and neurofibroma, in imaging bladder lipomas present as homogeneous lesions containing macroscopic fat. Only the liposarcoma and pelvic lipomatosis could also show similar features. The less differentiated liposarcomas tend to present more heterogeneous enhancement, irregular-shaped margins, and infiltrative behavior. Also, appropriate multiplanar reconstructions may allow the radiologist to determine it is an extravesical pelvic lipomatosis. Conclusion: Using CT and MRI, these lesions rich in adipose tissue can be distinguished from other lesions, and their diagnosis can be made to a great extent. However, a histopathological examination is required for a definitive diagnosis.


Nova Scientia ◽  
2018 ◽  
Vol 10 (21) ◽  
pp. 379-390
Author(s):  
Oscar David Jurado Patrón ◽  
Andrés Vargas López ◽  
Elma María Vega Lizama ◽  
Gabriel Alvarado Cárdenas ◽  
María Eugenia López Villanueva ◽  
...  

Introduction: The radiographic control of the root canal treatment can evaluate the healing of the periapical lesions. The objective of this study was to determinate the characteristics of the radiographic healing that was observed after one year, during follow-up sessions; so, the healing of the lesions according to the periapical pathology at the beginning of the treatment and the causes of failure of the endodontic treatments were recorded.Method: This is a prospective, observational, descriptive and longitudinal study, carried out in patients who attended control one year after endodontic treatment through the Periapical Index (PAI).Results: A total of 395 teeth of patients who underwent endodontic treatment one year prior to data collection, 87 presented radiogaphically observable periapical lesions; of these, 40 (45.97%) attended the control at one year. The frequency of cases in which some degree of radiographic healing was observed one year after treatment was 97.46%. The pathology with more cases of complete healing was periodontitis with sinus tract. In general, 84.61% of the cases decreased two levels in their PAI after one year. The 100% of the cases of failure presented vertical root fractures.Conclusion: The frequency of periapical healing after endodontic treatment is high. The main cause for the failure of the treatments documented in this study was the lack of coronal restoration that caused vertical fractures.


2020 ◽  
Vol 29 (10) ◽  
pp. 562-566
Author(s):  
Ma Yan ◽  
Zhou Xiaobo ◽  
Yuan Zhaoqi ◽  
Wang Xiuxia ◽  
Jin Rui ◽  
...  

Objective: The aim of this study was to present our experience with a kite flap in reconstruction of facial wounds after malignant tumour excision. Method: From October 2008 to September 2017, patients with facial malignant tumour were treated in the Xinjiang Uygur Autonomous Region Bazhou People's Hospital with kite flaps after complete excision. The survival rate, colour, cicatrix of the flap and patient satisfaction were recorded after surgery. Results: A total of 95 patients were included in the study. During follow-up, from six months to 8 years, all the kite flaps achieved primary closure and survived well, and the colour and texture were similar to the surrounding skin with no obvious scar. Dysfunction, complications and recurrence had not been reported. Conclusion: The kite flap may be a good option in reconstructing facial wounds after malignant tumour excision (diameters 1–5cm). It is a simple surgical method with sufficient blood supply and extensive adaptability. For patients in this study, no obvious scars were formed and the recipient site matched well with the donor site.


2020 ◽  
Vol 13 (7) ◽  
pp. e234699
Author(s):  
Lynn Lilly Varghese ◽  
Auric Bhattacharya ◽  
Praveena Sharma ◽  
Abhishek Apratim

Chronic apical periodontitis associated with dental pulp necrosis is the main cause of odontogenic extraoral cutaneous sinus openings. These tracts are often initially misdiagnosed unless the treating clinician considers a dental aetiology. This case report of a 19-year-old woman describes the diagnosis and treatment of an extraoral cutaneous sinus tract of odontogenic origin. Non-surgical conservative endodontic therapy was opted as the involved teeth were restorable. One month after the completion of obturation, there was closure of the sinus tract. One year follow-up showed complete resolution of the sinus tract with minimal scar formation.


Author(s):  
Pranav Gupta ◽  
Etti Goyal ◽  
A Dokania ◽  
Y Rizvi

ABSTRACT Papilloma is a histopathological term describing tumors of a classical finger-like or cauliflower morphology. Though benign, they carry profound malignancy potential and can present at numerous anatomical locations, such as skin, cervix, esophagus, respiratory tract, breast duct, etc. Papillomas over conjunctiva are not frequently encountered and carry special significance. A 60-year-old diabetic female presented with a left upper lid marginal sessile mass of 9 months duration with mild epiphora and foreign body sensation. On examination, a solitary, fleshy, sessile, polypoidal mass measuring 1 × 1 cm was seen, with irregular cauliflower-like surface present over lateral aspect of left upper lid, firm in consistency with raised edges. Visual acuity in right eye was 6/18→6/9 and left eye 6/36→6/9, intraocular pressure (IOP) was 14.6 mm Hg in both eyes by Schiotz tonometry. Complete excision of the lesion employing microsurgical technique with close apposition of lid margin using 6-0 Vicryl sutures was done under local anesthesia (LA). Histopathological examination revealed stratified squamous epithelium forming papillae with variable goblet cells supported by prominent branching fibrovascular cores in the center. A satisfactory cosmetic result was achieved. Follow-up of 6 months did not reveal any recurrence. A satisfactory functional and cosmetic result achieved. Squamous papillomas over lid margin are uncommon presentations. Even though benign they carry morbidity potential in the form of chronic epiphora, corneal erosions, and lid deformities if inadequately managed. How to cite this article Goyal E, Gupta P, Dokania A, Rizvi Y. Squamous Papilloma over Lid Margin: An Uncommon Presentation. Int J Adv Integ Med Sci 2016;1(3):128-130.


2019 ◽  
Vol 141 (3-4) ◽  
pp. 63-67

Chronic pilonidal sinus is an acquired skin disease resulting from chronic inflammation of an affected skin area. It creates a cyst with epithelized subcutaneous channels. The disease mostly affects younger men with elevated BMI and sedentary lifestyle being the main risk factors. The aim of this study was to compare wound healing times, seroma, wound infection and wound dehiscence frequency, average length of hospital stay and recurrence rate in patients undergoing first-time operation for chronic pilonidal sinus at the Surgery clinic of University hospital Mostar from June 2015 to June 2017, with recurrence rate monitoring for one one year after the operative procedure. The patients were divided into three groups by the type of operating procedure: excision with primary closure (23.0%), excision with healing by secondary intention (55.2%) and excision with Limberg flap closure (21.8%). Most of the patients included in this study had elevated BMI (72.4%). Patients who were operated using primary closure and Limberg flap closure had on average shorter wound healing times than patients operated with excision and secondary intention healing. Seroma frequency was highest in patients operated using primary closure (70.6%) and lowest in patients operated using Limberg flap closure (29.4%). Average length of hospital stay was 6.4 days (min 3, max 13; SD 1.919). There were no statistically significant differences in hospital stay between different types of operating procedures used. Patients operated using Limberg flap closure had two (10.5%) cases of recurrence in the one year period after the operation. There were seven (35.0%) recurrences of the disease in patients operated using primary closure and six (12.5%) recurrences in patients operated using healing with secondary intention. The difference in the number of recurrences between patients operated using primary closure, healing by secondary intention and Limberg flap closure was borderline statistically significant. We find that Limberg flap closure reduces postoperative complications and wound healing time which improves postoperative recovery.


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