Epithelial coccygeal course

Along with acute paraproctitis showed widespread purulent disease in area coccyx. It is characterized by the formation of abscesses, not related to the rectum.
These abscesses are formed on the place of epithelial coccygeal passage (congenital defect of development). He defines himself tube lined with multi-layer flat epithelium, outward opening one or several points of holes. The inside of the tube contains the sebaceous glands, which leads to the appearance of hair in the lumen of the tube and to the sebaceous secretions. Sometimes a tuft of hair sticking out of the hole in the skin.
Coccygeal passage in throughout life can never be nanaitsy. In such cases, it does not require any treatment.
More often, however, it raises the inflammatory process. All of a sudden pain in sacrococcygeal region, seal, sometimes reaching large size, the temperature rises to 38 - 39C C. For the maturation of skin abscess on it thins, blushes, and then he opened or spontaneously, or it should be done through surgery.
The operation can be performed in the conditions of clinic under local anesthesia. A cavity in the place opened abscess tamponiruut the Vishnevsky ointment for 2-3 days. Then produced bandaging of wounds with change tampons. Complete healing usually occurs within 10-14 days.
After opening the wound abscess sometimes completely and permanently cured. However, in most cases, abscesses again arise in case of trauma, long drive in the car, excessive cooling, etc.
Each relapse require repeated surgery, after which remain scars, additional moves, greatly complicating further radical surgery. It is therefore considered that if the abscess recurs at least twice, radical surgery should be performed without waiting for the next episode occurred.
Often festering epithelial coccygeal move confused with pryamokishechnye fistula, although the difference is quite obvious. First, attaching a hole epithelial coccygeal passage is located near the top of the coccyx (about 5-7 cm from the anus), while the outer hole pryamokishechnye fistula rarely is so far from the anus. Secondly, with the introduction of the PC probe into the course, he goes up to the top of the coccyx, while pryamokishechnye fistula - in the direction of the rectum (often leaving in its clearance).
Radical surgery is performed when there are no acute inflammation. It should be noted that at the opening of the abscess is important to produce longitudinal incision over the infiltration closer to the midline (i.e. to the primary epithelial coccygeal course), because the incisions in the side of the midline (that happens sometimes in connection with extensive inflammatory infiltration of surrounding tissues) further complicate the main operation, leading to the formation of additional cavities, moves and scars.
Radical surgery is the complete eradication of all epithelial coccygeal passage. This is achieved by oval-shaped excision of skin-fascial flap (up to the periosteum) with all the holes in the skin. In order not to leave in the tissue any moves in coccygeal the course before the operation introduces a solution of methylene blue. The operation ends with the overlay mattress seams.
Sometimes the wound should not be sewn tightly. It is better to enter the rest of the oral swab with Vishnevsky ointment. While this method leads to longer wound healing (sometimes up to 25-30 days), it provides a reliable outcome, excluding relapses.