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coccyx cyst is a congenital disease predetermined by the peculiarities of human embryonic development, in which a cavity lined with epithelium forms in the upper segment of the intergluteal fold under the skin.
Otherwise, this disease is called the coccyx fistula, epithelial coccygeal passage or pilonidal sinus.
There is a coccyx cyst mainly in men under 30 years old, although there have been cases of detection of the disease in women. For a long time it may not appear, you can determine its presence visually if you find a small hole in the region of the gluteal line, at a point 7-10 cm away from the anus.
Sometimes the course is deep, it may resemble a small funnel.
Symptoms of a coccyx cyst
The appearance of neoplasms in the coccyx is accompanied by the following symptoms:
a foreign object is felt in the intergluteal fold, causing discomfort when moving;
in the coccyx area, the skin turns red and swells, inflammation can be of any size, even transgress the gluteal line to the right or left;
a hole appears between the buttocks, from where a small infiltrate or pus arises;
during an exacerbation, secondary holes may appear next to the first, which serve as exit channels for the coccyx cyst. If such a move is active, secretions ooze from it, passive openings heal;
body temperature rises;
there is pain when sitting.
Causes of a coccyx cyst
The coccyx fistula is associated with a defect in the development of the caudal region of the embryo. It consists in the presence of a canal lined with epithelium under the intergluteal fold. In most cases, this condition does not manifest itself in any way, only under special circumstances inflammation can begin.
According to experts, an abundant hairline in this area leads to a coccygeal cyst, which, with a deep fold between the buttocks, contributes to abnormal hair growth and immersion in the skin, which causes the disease.
In addition, there are some factors that can provoke the manifestation of a cyst. Among them note:
blocked pores, follicles;
passive lifestyle;
heredity;
various infectious diseases;
low immunity;
hypothermia;
mechanical injury.
Sequelae of a coccyx cyst
The fistula of the coccyx has the form of a narrow tube that opens on the skin through one or more holes. Under certain conditions (injuries, infections, hypothermia), an inflammatory process develops.
Inflammation of the coccyx cyst provokes purulent discharge, which expands, and subsequently destroys the course. Surrounding tissues suffer, an abscess is formed, which, breaking out, leads to the emergence of a new hole.
An infection can enter the canal. In this case, there is an exacerbation of inflammation of the coccyx cyst, accompanied by pain, high fever, swelling and redness of the skin.
The result of an unfinished treatment process or mistakes made in the eradication of the epithelial coccygeal passage may be the following complications:
the appearance of a secondary and, as a rule, multiple fistula;
recurrent abscess;
purulent inflammation (phlegmon).
Dermoid cyst of the coccyx
The coccyx dermoid is a benign formation that forms when elements of the germ layers are displaced under the skin layer, which includes hair follicles, parts of the ectoderm, sebaceous glands and pigment cells.
The sacrococcygeal dermoid during growth leads to deviation of the coccyx and the appearance of symptoms that are very similar to those of a coccyx cyst.
Previously, both of these diseases were considered identical and were treated in the same way. Now they have been differentiated, although there are no big differences in the diagnosis, but the etymological features of these formations are different. The main difference is that with the coccygeal course there is a primary opening in the fold between the buttocks, occasionally veiled by extensive suppuration. The tumor formation in the dermoid cyst of the coccyx, even with acute suppuration, has a clear capsule. True, it can break through with advanced cases of the disease, in this case, only the primary opening of the coccyx cyst serves as a difference.
The dermoid cyst of the coccyx is localized in the middle part of the intergluteal line with the transition to the subcutaneous tissue of the coccyx. Often accompanied by an opening in the form of an epithelial passage (fistula). Through it, a constant release of the contents of the formation is ensured, blockage of the channel is fraught with infection and inflammation.
Dermoid cyst of the coccyx in an uncomplicated form can develop asymptomatically for years, occasionally manifesting pain after a long sitting. The provocateur of clinical manifestations are suppurations, which lead to an increase in temperature, the appearance of throbbing pains, difficulty in such actions as bending over, squatting and the usual sitting position.
The coccyx dermoid lends itself only to surgical treatment, during which the epithelial passage, scars and possible fistulas are cut out.
Surgery to remove a coccyx cyst
The most effective way to get rid of this disease is surgery. It is carried out in all cases of uncomplicated course of the disease and at any stage of inflammation of the coccyx cyst. The earlier the operation was performed, the sooner the body will recover from the consequences of the disease and surgical actions, in addition, the likelihood of relapses and complications in this case is reduced.
During the operation, the doctor removes the very source of the disease – the epithelial canal with its primary and secondary openings.
Elimination of the coccyx cyst is practiced during the period of remission, although there are times when it is necessary to perform surgery at the time of exacerbation. The operation takes place under local or general anesthesia and lasts 20 minutes. – an hour, is easily tolerated by the patient. The wound heals for about a month, the ability to work is restored after 3 weeks.
Excision of the coccyx cyst can be carried out in different ways, the choice of which depends on the location of the formation and the complexity of the epithelial coccygeal passage. The following methods of surgical removal of the focus of the disease are used:
The doctor excises the cyst of the coccyx entirely, sutures the wound to the bottom, thereby creating natural drainage. In the postoperative period, the patient is under observation. This method is used in the complicated form of the coccygeal cyst and the presence of an open wound.
The surgeon excised the cyst completely, but sewing up the wound, leaves a hole for drainage. This method is good for a closed wound, when relapse is more possible, as well as during remission.
The Bascom method is different in that the coccyx cyst is removed under the skin in the direction from the primary hole, which is completely sutured, to the secondary ones, drainage is left in them to exit the infiltrate.
The Karidakis method assumes that, together with the coccyx cyst, a piece of skin is excised, the affected area is somewhat mixed, leading the wound to the intergluteal line. This method speeds up postoperative recovery and reduces the risk of relapses, as well as complications.