Pilonidal Abscess: The Very Bare (Back) Basics

This month we want to touch gently on treating pilonidal abscesses as we continue on our series on abscess incision and drainage. A pilonidal cyst or abscess is a fluid-filled pocket of dead skin cells, or pus. These pockets occur on the back over the tailbone, coccyx, or natal cleft. Pilonidal cysts often remain cysts and do not get infected. If the abscess is ignored or spreads (forms a fistula), then the practitioner should be concerned with a possible bacteremia or systemic infection. Infected pilonidal cysts are painful and sometimes dangerous.     A pilonidal abscess is lurking beneath the surface just above the natal cleft. It is much deeper than it actually appears when palpated. The scarring present is from prior I&Ds of the abscess. Photos by Martha Roberts.   Patients often present to the emergency department embarrassed and unsure of their diagnosis. They think they are doing something wrong, are unclean, or do not wash themselves well. This is not the case, and it is important to assure them they did not cause their ailment. Patients mainly complain of pain over their spine or above their buttock, redness or swelling over the area, discharge, and if infected, fever, nausea, or possible signs and symptoms of sepsis.   Many theories explain why some people develop pilonidal cysts or abscesses. Occasionally they occur due to ingrown hairs or infected hair follicles. Another theory is that pilonidal cysts appear after trauma to that region of the body. “[Ma...
Source: The Procedural Pause - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs