Pilonidal cyst, also known as pilonidal sinus or epithelial coccygeal tract, is translated from Latin as “nest with hair”. This is a congenital pathology, which is an anomaly localized in the space between the buttocks. More often the problem occurs in boys, and it needs to be solved together with the doctor. We talked more about the disease and how it is treated with a doctor of the highest category, a pediatric surgeon at the SM-Clinic for children Sergey Ivanovich Sednev.
Why pilonidal cysts occur
The disease is usually diagnosed in adolescence. At this time, abundant growth of hair on the body begins, there is an increased production of sebaceous and sweat glands when the hormonal background is activated. Then the cyst increases – and the inflammatory process begins. That's how they notice her.
“Pilonidal cysts were first brought to the fore in medical circles during World War II, when several thousand US troops showed signs of the disease. Due to the fact that many patients often had to drive off-road vehicles on bad roads, the disease was called “jeep disease” ”, – Sergey Sednev comments.
Who is at risk
“Risk factors for pilonidal cysts include obesity, family history, prolonged sitting, increased hair growth in the buttocks, sacrum, and coccyx. More often, the disease manifests itself in peoples with increased hairiness “, – says Sergey Sednev.
But it is important to say that lifestyle factors can also provoke inflammation. Including trauma, lack of hygiene, or hypothermia in the area of the cyst.
Signs that should not be ignored
In some cases, a pilonidal cyst may leak without any noticeable signs and can only be seen on visual inspection. When a funnel-shaped retraction and volume formation appears on the skin in the coccyx area, which can spread from the intergluteal fold.
“The patient begins to experience discomfort in the area of the sacrum and coccyx, feel pain, itching, burning. Sometimes, through the fistulous openings, there is a release of ichor, pus, a clear liquid, which is manifested by pathological spots on the underwear, the appearance of an unpleasant odor “, – explains Sergey Sednev.
With inflammatory and suppurative processes in the coccyx area, inflammation appears, pronounced edema. Also, all this can be accompanied by chills, fever – and then it is important to show the child to a pediatric surgeon as soon as possible. The doctor will prescribe functional studies, such as ultrasound and MRI of the sacrococcygeal region, to confirm the diagnosis and prescribe treatment.
When you can not do without surgery
“In most cases, pilonidal cysts are treated surgically. Surgical treatment of the coccygeal passage involves the excision of the skin-fatty area on which the passages or fistulous openings are located. At the very beginning of the operation, the moves are specially stained to minimize the risk of leaving any hole unnoticed. This measure allows you to radically remove the formation with all fistulas and avoid recurrence, ”, says Sergey Sednev.
With a complicated course of the pilonidal cyst, the operation is performed in two stages. At the first stage, there is a fight against acute purulent inflammation: opening of the purulent focus, sanitation, removal of pathological elements from the cyst cavity (hair, sebaceous masses, and so on). Then the patient takes the drugs prescribed by the doctor, goes to dressings every day, and, if necessary, undergoes physiotherapy. And only after that, at the second stage, the cyst is excised.
The operation is performed under intubation anesthesia. Its duration depends on the size, localization of the cyst, the degree of prevalence of fistulous passages and other anatomical features. But speaking on average, it is from 30 minutes to 2 hours.
“In the first hours or days, bed rest is necessary. You can get up and walk on your own the very next day after the operation, sit – after 7-14 days. A long stay in the hospital is not required, as early as 2-3 days the patient can be discharged for outpatient aftercare. Mandatory observation of the surgeon is necessary at 1, 3 and 6 months after the operation”, concludes Sergey Sednev.
It is important to remember that in advanced conditions, the number of fistulas increases and the process becomes chronic, so the sooner you contact a pediatric surgeon, the better the recovery period will be.