Background and objective: Umbilical sinus develops either in an abnormal embryonal remnant of Omphalomesenteric & Urachal ducts, or secondary to hair insertion in the umbilical skin with resultant suppuration ending in what is named umbilical pilonidal sinus.This study viewed the relative distribution of these pathologic variants and results of management options adopted. Methods: All patients (n=28) suffering from umbilical sinus disease during the period of 5 years, between 1st Jan 2015 to 31st Dec 2019 are evaluated according to their pathologic types and therapeutic options. For hair sinuses, the conservative approach was initiated, its failure demanded exploration without excision. For sinuses secondary to embryonal remnants, the treatment was complete tract excision. Results: Umbilical pilonidal sinus constitutes the majority of sinuses in the umbilicus (n=26) (92.86%), suppuration in Embryonal remnants was far less common (n=2) (7.14%). The conservative management was effective in 24 (92.3%) out of 26 patients who were presented with umbilical pilonidal sinus, two patients got recurrence (7.14%), and necessitated tract exploration. Sinuses secondary to embryonal remnants (7.14%), were dealt with complete tract excision. In the results also; umbilical pilonidal sinuses were associated with young age group, (78.57% were between 21 and 30 years of age), male gender (85.71%) and overweight, (60.71%). Conclusion: The conservative approach was successful in the majority of cases, failure was mainly due to incomplete hair removal, for such cases a valid alternative was sinus exploration. Sinus tract excisions were spared for sinuses secondary to Omphalomesenteric & Urachal sinuses.
Background and objective: Rectal bleeding is a common symptom that has many patterns, but none of them are accurately diagnostic. One newly noticed pattern can be diagnostic, namely, the squirting pattern, for which this study was conducted. Methods: The study was conducted between Jan 2013 and Jun 2018, including 132 patients who presented with a squirting pattern of rectal bleeding, which is thought to be due to hemorrhoids. All these patients underwent clinical evaluation and anoscopy, and the majority (n=94) underwent colonoscopy. Results: At the time of clinical examination, 23 patients showed actively bleeding hemorrhoids. Fifteen patients were not convinced to undergo colonoscopy. The rest (n=94) who had no visible active bleeding at the time of examination underwent a colonoscopy to exclude other possible rectal or colonic pathology. All the 94 colonoscopies were negative for other bleeding sources. Two patients showed single benign non bleeding polyps, which were excised and biopsied. Conclusion: This study highlights a pattern of rectal bleeding that is not described before and proved it is a reliable diagnostic pattern for hemorrhoids. It also showed that colonoscopy is not needed in patients below 40 years complaining of squirting rectal bleeding unless indicated for some other reason. This decision is to be made very carefully. Keywords: Squirting rectal bleeding; Hemorrhoids; Colonoscopy.
Background and objective: Many surgical options are known to treat chronic pilonidal sinus disease; the procedure that has the least recurrence rate is the open method. This study aimed to evaluate the effect of adding one step in management, on the recurrence rate of the same procedure. Methods: This is a prospective study, started at 1st Feb. 2018; the last data collection was at 31 Jan. 2020. Thirt-eight patients included in the study, all were suffering from chronic sacrococcygeal pilonidal sinus disease. Sinus excision and lying open the wound to heal by secondary intention is the procedure that is adopted.At time of follow up, frequent separation of wound edges and breaking of any premature bridging of skin at the excision site, were adopted, local anesthesia was needed in 7 patients. Results: The recurrence rate for lying open the wound to heal by secondary intention is significantly reduced from (8-21%) to (2.63%) by adding one step in management during the follow up period, this step involved the frequent separation of wound edges and breaking of any premature bridging of skin even if local anesthesia is needed. Conclusion: Preventing premature bridging of wound skin after surgical excision of pilonidal sinus can significantly reduce the recurrence rate of the procedure
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.