Epithelial coccygeal passage

Along with paraproctitis, rectal disease is widespread , which is characterized by the formation of abscesses in the coccyx region that are not associated with the rectum, the epithelial coccygeal passage.

[1], [2], [3], [4], [5], [6], [7]

Causes of the epithelial coccygeal path

What causes the epithelial coccygeal passage?

The origin of these abscesses is due to the epithelial coccygeal course - a defect in the development of the skin, caused by incomplete reduction of the former tail muscles. Stroke is a narrow epithelial tube located along the middle line in the inter-saline fold, terminating blindly in the subcutaneous tissue and not connected with the sacrum or coccyx. The products of the vital activity of the epithelium lining the course are distinguished through the pinholes on the skin, which are usually called primary. In the event of mechanical trauma or blockage of primary holes, the content lingers in the lumen of the stroke, and inflammation occurs. The destruction of the stalk leads to the spread of the inflammatory infiltrate into the fatty tissue and the formation of an abscess in it. The abscess breaks through the skin. As a result, an external fistula opening is formed, which is considered secondary. With frequent relapses of inflammation, there may be several purulent cavities.

Pilonidal disease (epithelial coccygeal passage) is usually found in young men with white skin color and pronounced hair. In the coccyx region along the middle line or adjacent to it one or several skin deepenings sometimes form a hollow, often containing hair. Pathological changes in this area usually occur asymptomatically; When the infection becomes infected, the pain syndrome develops.

Inflammation of the epithelial coccygeal path is often diagnosed as purulent fistulas of the coccygeal region, coccygeal cyst or dermoid coccyx cyst. The coccygeal course can not be festered for the rest of your life. In these cases, he does not require any treatment.

Symptoms of the epithelial coccygeal path

Symptoms of epithelial smoking

The first clinical symptom of inflammation of the epithelial course is pain in the sacrococcygeal region. Then an infiltrate with clear contours appears, the body temperature rises to 37-38 ° C. The skin above the infiltrate becomes swollen, hyperemic. The abscess is opened spontaneously or as a result of surgical intervention. After opening the abscess, the wound heals completely. However, most abscesses are repeated after hypothermia, minor injuries, etc. After numerous relapses, scars remain, additional strokes complicate the subsequent radical operation, therefore some authors consider it necessary to perform a radical operation after two relapses of inflammation.

Diagnostics of the epithelial coccygeal path

Diagnosis of epithelial smoking

The main diagnostic sign of the epithelial coccygeal path is the primary fistulous holes, which are depressions of the skin of various sizes - from point-like to 2-5 mm in diameter. Sometimes you can observe in the primary hole a bunch of hair in the form of a brush.

Finger examination of the rectum, supplemented by sounding purulent fouling, allows differential diagnosis of the epithelial coccygeal pathway with other diseases accompanied by the formation of fistulas in the sacrococcygeal region and perineum (fistulas of the rectum, dermoid cysts, osteomyelitis of the sacrum and coccyx). When the secondary holes are located near the anus, 1 % methylene blue solution is injected into the hole of the main fistula with a syringe . If there is an epithelial coccygeal pathway, the contrast material will be discharged through its primary opening, while in the fistulas of the rectum it will appear in the luminal gut.

[8], [9], [10], [11], [12], [13], [14], [15], [16]

Treatment of the epithelial coccygeal path

Treatment of epithelial smoking

Treatment of the epithelial smoking course is surgical. Radical operation consists in complete elimination of the entire epithelial coccygeal path, which is achieved by oval excision of the cutaneous-fascial flap with all the holes in the skin. In order not to leave any fistulous passage in the cellulose, a methylene blue solution is injected into the primary hole before the operation. Antibiotics, as a rule, are not required.