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Age / Sex : 16 / F
Chief complaint: recurrent intergluteal abscess
1) What is your impression?
Two weeks later, you can see the final diagnosis with a brief discussion of this case.
(Quiz는 quiz일 뿐이오니 답안은 한개만 보내주시기 바라오며, 복수의 답안을 보내주시는 분은 정답이 포함되어 있더라도 부득이 semi-correct answer로 처리토록 하겠습니다.)
Courtesy: 고성혜(Sung Hye Koh), 한림대성심병원(Hallym University Sacred Hospital)
Diagnosis: Pilonidal cyst
Discussion
Findings:
US Sagittal
and transverse scan show a thick walled cavitary lesion in subcutaneous fat
layer of intergluteal area. US demonstrates multiple hyperechoic lines (arrows)
that correspond to hair fragements within the cyst.
Differential Diagnosis: Infected epidermal inclusion cyst
Diagnosis:
Pilonidal cyst, Pilonidal sinus disease
Discussion:
Pilonidal
cyst is a cyst or abscess along the intergluteal crease that often contains
hair and skin debris. Pilonidal means nest of hair. The term was first used by
Herbert Mayo in 1833. The cause of pilonidal disease is not clear. It is
thought to be caused by hair growing into the skin in the crease between the
buttocks. Numerous operative and conservative treatments have been described
fot the management of the disesase: however, there is still debate on the ideal
treatment. Chronic condition is treated with wide excition and primary closure
or secondary healing. The surgeon needs to know the dimensions, location,
borders, and branches of the pilonidal sinus cavity in order to plan the
operatve strategy.
References:
(1) Mentes O, Oysul A, Harlak A, Zeybek N, Kozak O, Tufan T.
Ultrasonography accurately evaluates the dimension and shape of the pilonidal
sinus. Clinics 2009;64(3):189-192.
(2) Quayle. J. Pilonidal sinus. COLORECTAL DISEASE 2003;5(4):379.
(3) 김선미, 신명진, 최수정, 김성문. 천골미골 모소루의 자기공명영상 소견. 대한방사선의학회지 2000;43(5):615-621.
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