WordNet

commit a sin; violate a law of God or a moral law (同)transgress, trespass
violent and excited activity; "they began to fight like sin" (同)hell
estrangement from god (同)sinfulness, wickedness
an act that is regarded by theologians as a transgression of Gods will (同)sinning
the 21st letter of the Hebrew alphabet
any of various air-filled cavities especially in the bones of the skull

PrepTutorEJDIC

〈U〉(宗教・道徳上の)『罪』 / 〈C〉(宗教・道徳上の)『罪の行為』,罪悪 / 〈C〉《特におどけて》違反(過失)の行為 / (宗教・道徳上の)おきてを破る,罪を犯す / (…に)違反(過失)をする,背く《+『against』+『名』》
sine
洞(どう)(骨や組織の中の穴・くぼみなど);静脈洞

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/05/21 15:38:18」(JST)

wiki en

A pilonidal cyst, also referred to as a pilonidal abscess, pilonidal sinus or sacrococcygeal fistula, is a cyst or abscess near or on the natal cleft of the buttocks that often contains hair and skin debris.^[1]

Signs and symptoms

Pilonidal cysts are often very painful, and typically occur between the ages of 15 and 35.^[2] Although usually found near the coccyx, the condition can also affect the navel, armpit or genital region,^[3] though these locations are much rarer.

Symptoms include:^[4]

Pain/discomfort or swelling above the anus or near the tailbone that comes and goes
Opaque yellow (purulent) or bloody discharge from the tailbone area
Unexpected moisture in the tailbone region
Discomfort with sitting on the tailbone, doing sit-ups or riding a bike (any activities that roll over the tailbone area)

Some people with a pilonidal cyst will be asymptomatic.^[5]

Pilonidal sinus

A sinus tract, or small channel, may originate from the source of infection and open to the surface of the skin. Material from the cyst may drain through the pilonidal sinus. A pilonidal cyst is usually painful, but with draining, the patient might not feel pain.

Causes

One proposed cause of pilonidal cysts is ingrown hair.^[6] Excessive sitting is thought to predispose people to the condition because they increase pressure on the coccyx region. Trauma is not believed to cause a pilonidal cyst; however, such an event may result in inflammation of an existing cyst. However there are cases where this can occur months after a localized injury to the area. Some researchers have proposed that pilonidal cysts may be the result of a congenital pilonidal dimple.^[7] Excessive sweating can also contribute to the cause of a pilonidal cyst. Moisture can fill a stretched hair follicle, which helps create a low-oxygen environment that promotes the growth of anaerobic bacteria, often found in pilonidal cysts. The presence of bacteria and low oxygen levels hamper wound healing and exacerbate a forming pilonidal cyst.^[8]

The condition was widespread in the United States Army during World War II. The condition was termed "jeep seat" or "Jeep riders' disease", because a large portion of people who were being hospitalized for it rode in Jeeps, and prolonged rides in the bumpy vehicles were believed to have caused the condition due to irritation and pressure on the coccyx.

Treatment

Pilonidal cyst two days after surgery.

Treatment may include antibiotic therapy, hot compresses and application of depilatory creams.

In more severe cases, the cyst may need to be lanced or surgically excised (along with pilonidal sinus tracts). Post-surgical wound packing may be necessary, and packing typically must be replaced once daily for 4 to 8 weeks. In some cases, two years may be required for complete granulation to occur. Sometimes the cyst is resolved via surgical marsupialization.^[9]

Surgeons can also excise the sinus and repair with a reconstructive flap technique, such as a "cleft lift" procedure or Z-plasty, usually done under general anesthetic. This approach is especially useful for complicated or recurring pilonidal disease, leaves little scar tissue and flattens the region between the buttocks, reducing the risk of recurrence.^[8]

Pilonidal cysts recur and do so more frequently if the surgical wound is sutured in the midline, as opposed to away from the midline, which obliterates the natal cleft and removes the focus of shearing stress. An incision lateral to the intergluteal cleft is therefore preferred, especially given the poor healing of midline incisions in this region. A minimally invasive surgical technique, based on J. Bascom's research, was developed in Israel by Moshe Gips et al., back in 2008 [Gips M, et al. "Minimal surgery for pilonidal disease using trephines: description of a new technique and long-term outcomes in 1,358 patients". Dis Colon Rectum 2008; 51: 1656-62]. This procedure consists in the employment of trephines or of biopsy punches which only "core out" and remove the diseased tissue and cyst ("fistulectomy"), without any lateral incision. Therefore, only small surgical "holes" (2 to 4) will residue, measuring, usually, 6 to 8 mm (1/4 of an inch), thus healing very quickly. Work or school activities will be resumed in one or two days, without or with minimal postoperative pain. The excellent outcome of the Gips'procedure (slightly modified) has been confirmed by a research recently conducted by Luigi Basso et al. in Rome, Italy on 110 patients [Basso L, et al. "Outcome of 110 cases of Pilonidal Disease treated by modified Gips' procedure. A plea for minimally invasive surgery". 2015: in progress]. One other minimally invasive technique involving the use of a fistuloscope was introduced in 2014 (Endoscopic Pilonidal Sinus Treatment or EPSiT), but this seems pointlessly elaborated and expensive compared to the Gips' technique [Meinero P, et al. "Endoscopic pilonidal sinus treatment (E.P.Si.T.)". Tech Coloproctol 2014; 18: 389-92]. An additional, minimally invasive technique is to treat pilonidal sinus with fibrin glue. This technique is less painful than traditional excisional techniques and flaps, can be performed under local or general anaesthesia, does not require dressings or packing and allows return to normal activities within 1 to 2 days. Long term outcome and recurrence rates are, however, uncertain. ^[10]^[11]^[12]^[13]

Differential diagnosis

A pilonidal cyst can resemble a dermoid cyst, a kind of teratoma (germ cell tumor). In particular, a pilonidal cyst in the gluteal cleft can resemble a sacrococcygeal teratoma. Correct diagnosis is important because all teratomas require complete surgical excision, if possible without any spillage, and consultation with an oncologist.

Etymology

Pilonidal means nest of hair and is derived from the Latin words for hair (pilus) and nest (nidus).^[2] The condition was first described by Herbert Mayo in 1833.^[14]^[15] R.M. Hodges was the first to use the phrase pilonidal cyst to describe the condition in 1880.^[16]^[17]

Notes

^ Klass, Alan (November 1, 1956). "The So-Called Pilo-Nidal Sinus". Canadian Medical Association Journal 75 (9): 737–742. PMC 1823328. PMID 13364825. Retrieved February 8, 2013.
^ ^a ^b "Pilonidal Cyst: Definition". Mayo Clinic. December 5, 2012. Retrieved February 8, 2013.
^ Rao, Amrith; Sharma, Mohit; Thyveetil, Mabel; Karim, Omer (December 2006). "Penis: An Unusual Site for Pilonidal Sinus". International Urology and Nephrology 38 (3–4): 607–608. doi:10.1007/s11255-005-4761-5. |accessdate= requires |url= (help)
^ Sternberg, Jeffrey. "What Is Pilonidal Disease". Retrieved November 14, 2014.
^ Doerr, Steven. "Pilonidal Cyst". eMedicineHealth. p. 1. Retrieved February 8, 2013.
^ "Pilonidal Cyst: Causes". Mayo Clinic. December 5, 2012. Retrieved February 8, 2013.
^ da Silva JH (2000). "Pilonidal cyst: cause and treatment". Dis. Colon Rectum 43 (8): 1146–56. doi:10.1007/bf02236564. PMID 10950015.
^ ^a ^b Bascom, John; Bascom, Thomas (October 2002). "Failed Pilonidal Surgery". Archives of Surgery 137 (10): 1146–50. doi:10.1001/archsurg.137.10.1146. PMID 12361421.
^ Prolonged delay in healing after surgical treatment of pilonidal sinus is avoidable
^ Fibrin glue in the treatment for pilonidal sinus: high patient satisfaction and rapid return to normal activities, E Elsey, JN Lund Techniques in coloproctology 2013 17 (1), 101-104
^ Fibrin glue in the treatment of pilonidal sinus: results of a pilot study JN Lund, SH Leveson Diseases of the colon & rectum 2005 48 (5), 1094-1096
^ Fibrin glue may be better than surgery for pilonidal sinus: Results of a prospective, randomized, controlled trial and 2-year follow up S Liptrot, S Leveson, J Lund DISEASES OF THE COLON & RECTUM 2008 51 (5), 710-711
^ Isik A, Eryılmaz R, Okan I, Dasiran F, Firat D, Idiz O, Sahin M. The use of fibrin glue without surgery in the treatment of pilonidal sinus disease. Int J Clin Exp Med. 2014 Apr 15;7(4):1047-51
^ Lanigan, Michael (September 27, 2012). "Pilonidal Cyst and Sinus". Medscape. WebMD. Retrieved February 8, 2013.
^ Saad, Saad; Shakov, Emil; Sebastian, Vinod; Saad, Adam (2007). "The use of Wound Vacuum-assisted Closure (V.A.C.™) system in the treatment of Recurrent or Complex Pilonidal Cyst Disease: Experience in 4 Adolescent Patients". The Internet Journal of Surgery 11 (1). doi:10.5580/382. ISSN 1528-8242. |accessdate= requires |url= (help)
^ Hodges, RM (1880). "Pilonidal sinus". The Boston Medical and Surgical Journal 103: 485–586.
^ Kanerva 2000, p. 821

References

NHS Choices for pilonidal sinus treatment

Kanerva, Lasse (2000). Handbook of Occupational Dermatology. Springer. ISBN 9783540640462.

Pictures of pilonidal sinus and glue treatment http://www.learncolorectalsurgery.com/#/pilonidal-sinus/4549818668

Pictures of Rhomboid Flap http://www.learncolorectalsurgery.com/#/pilonidal-sinus-rhomboid/4549818699

UpToDate Contents

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1. 殿間の毛巣病：臨床症状および診断 intergluteal pilonidal disease clinical manifestations and diagnosis
2. 殿間の毛巣病のマネージメント management of intergluteal pilonidal disease
3. 肛門周囲膿瘍：臨床症状、診断、および治療 perianal abscess clinical manifestations diagnosis treatment
4. 汗腺膿瘍（にきび）の病因、臨床的特徴、および診断 pathogenesis clinical features and diagnosis of hidradenitis suppurativa acne inversa
5. Z形成術 z plasty

English Journal

A rare case of vulval pilonidal sinus: incidental diagnosis.

Kushwaha P1, Merritt A1, Aslam MB1.
BMJ case reports.BMJ Case Rep.2015 Jul 27;2015. pii: bcr2014204693. doi: 10.1136/bcr-2014-204693.
A 63-year-old woman presented with a 4-week history of vulval bleeding. On examination, an 8 mm fleshy irregular vascular lesion was present on the vulva in the periclitoreal area. This vulval lesion was treated by surgical excision. Histological analysis showed irregular pieces of skin partly cov
PMID 26216921

Pilonidal sinus involving the nasal bridge: a rare manifestation.

Junaid M1, Ahmed SQ2, Kazi M2, Ali NS3.
BMJ case reports.BMJ Case Rep.2015 Jul 6;2015. pii: bcr2015209948. doi: 10.1136/bcr-2015-209948.
Pilonidal sinus is very commonly associated with the sacrococcygeal area, but its presence within the head and neck is still unknown to many. Once diagnosed, it is easy to treat and should, therefore, be kept in mind as a possibility when coming across a discharging sinus swelling. We share our expe
PMID 26150636

Eyedrop-shaped, modified Limberg transposition flap in the treatment of pilonidal sinus disease.

Sabuncuoglu MZ1, Sabuncuoglu A2, Dandin O3, Benzin MF4, Celik G4, Sozen I5, Cetin R6.
Asian journal of surgery / Asian Surgical Association.Asian J Surg.2015 Jul;38(3):161-7. doi: 10.1016/j.asjsur.2015.03.007. Epub 2015 Apr 23.
BACKGROUND: Pilonidal sinus disease is an inflammatory disease seen in the intergluteal region, which is a commonly encountered problem in surgical practice that mostly affects young people. The aim of this study is to assess the effectiveness of the modified Limberg flap technique with eyedrop exci
PMID 25912103

Japanese Journal

II．痔瘻の診断

栗原浩幸,金井忠男,金井慎一郎,金井亮太,赤瀬崇嘉,黒田敏彦
日本大腸肛門病学会雑誌 66(10), 999-1010, 2013
肛門周囲膿瘍や痔瘻を診断するということは，その病変が肛門管内に原因があって発生した膿瘍あるいは瘻管なのかを判断し，それがどのような型なのかを分類することである．したがって診断には肛門周囲膿瘍と痔瘻の分類を述べることが不可欠であり，本稿ではわれわれが提唱した痔瘻の新分類を取り上げ，それに則した診断について述べた．診断には症状を問診するとともに視診・指診を行う．必要に応じて瘻管造影やMRIなどの画像診 …
NAID 130003385078

A Case of Pilonidal Sinus Treated Using Kshara Sutra Made in Japan (Kanazawa Sutra I)

畑嘉高,増田芳夫
日本大腸肛門病学会雑誌 66(3), 183-187, 2013
… We report a patient with pilonidal sinus who was treated using Kshara Sutra made in Japan (Kanazawa Sutra I) and achieved a good result. … We observed the primary orifice at 3 and 7 o'clock and diagnosed low inter-sphincteric fistulas which were not associated with the abscess in the sacral region, which we diagnosed as pilonidal sinus. … Three days later we treated the pilonidal sinus using Kanazawa Sutra I. …
NAID 130003369840

トリマーの指尖部に生じた毛巣洞に骨髄炎を合併した1例

海老原吾郎,池田全良,小林由香,持田譲治,岡義範
関東整形災害外科学会雑誌 42(2), 79-82, 2011-04-01
NAID 10027971140

Related Pictures

★リンクテーブル★

リンク元	「毛巣瘻」「毛巣洞」「pilonidal cyst」

「毛巣瘻」

Pilonidal cyst
	Two pilonidal cysts that have formed in the gluteal cleft of an adult man.
Classification and external resources
ICD-10	L05
ICD-9	685
DiseasesDB	31128
eMedicine	emerg/771
MeSH	D010864

　　[★]

英: pilonidal sinus, piliferous sinus, coccygeal sinus
同: 毛巣嚢胞 pilonidal cyst、ジープ病 jeep disease、毛巣洞

[show details]

毛巣嚢胞 : 約 12,600 件
ジープ病 : 約 1,300 件
毛巣洞 : 約 14,300 件
毛巣瘻 : 約 36,500 件

概念

皮膚に刺さった毛の周辺で肉芽組織と扁平上皮で囲まれた瘻孔が形成されるものをいう。
仙骨部に多発し、特に臀部に多毛傾向のある若年男性に多発する。
治療は肉芽組織を切除する。

参考

1. 写真

http://www.dermis.net/bilder/CD198/550px/img0095.jpg

2. 写真

http://wikisurgery.com/images/b/bc/Pilonidal-sinus.jpg

3. 英語

http://www.kimayahealthcare.com/AilmentDetail.aspx?AilmentID=191&AboutID=1

「毛巣洞」

　　[★]

英: pilonidal sinus
関: 毛巣嚢胞、毛巣瘻

「pilonidal cyst」

　　[★] 毛巣嚢胞

関: pilonidal sinus

[1] Klass, Alan (November 1, 1956). "The So-Called Pilo-Nidal Sinus". Canadian Medical Association Journal 75 (9): 737–742. PMC 1823328. PMID 13364825. Retrieved February 8, 2013.

[Mayoclinic-2] "Pilonidal Cyst: Definition". Mayo Clinic. December 5, 2012. Retrieved February 8, 2013.

[3] Rao, Amrith; Sharma, Mohit; Thyveetil, Mabel; Karim, Omer (December 2006). "Penis: An Unusual Site for Pilonidal Sinus". International Urology and Nephrology 38 (3–4): 607–608. doi:10.1007/s11255-005-4761-5. |accessdate= requires |url= (help)

[symptoms-4] Sternberg, Jeffrey. "What Is Pilonidal Disease". Retrieved November 14, 2014.

[emed2-5] Doerr, Steven. "Pilonidal Cyst". eMedicineHealth. p. 1. Retrieved February 8, 2013.

[title-Pilonidal_cyst._Mayo_Clinic-6] "Pilonidal Cyst: Causes". Mayo Clinic. December 5, 2012. Retrieved February 8, 2013.

[pmid10950015-7] Silva JH (2000). "Pilonidal cyst: cause and treatment". Dis. Colon Rectum 43 (8): 1146–56. doi:10.1007/bf02236564. PMID 10950015.

[Bascom-8] Bascom, John; Bascom, Thomas (October 2002). "Failed Pilonidal Surgery". Archives of Surgery 137 (10): 1146–50. doi:10.1001/archsurg.137.10.1146. PMID 12361421.

[9] Prolonged delay in healing after surgical treatment of pilonidal sinus is avoidable

[10] Fibrin glue in the treatment for pilonidal sinus: high patient satisfaction and rapid return to normal activities, E Elsey, JN Lund Techniques in coloproctology 2013 17 (1), 101-104

[11] Fibrin glue in the treatment of pilonidal sinus: results of a pilot study JN Lund, SH Leveson Diseases of the colon & rectum 2005 48 (5), 1094-1096

[12] Fibrin glue may be better than surgery for pilonidal sinus: Results of a prospective, randomized, controlled trial and 2-year follow up S Liptrot, S Leveson, J Lund DISEASES OF THE COLON & RECTUM 2008 51 (5), 710-711

[13] Isik A, Eryılmaz R, Okan I, Dasiran F, Firat D, Idiz O, Sahin M. The use of fibrin glue without surgery in the treatment of pilonidal sinus disease. Int J Clin Exp Med. 2014 Apr 15;7(4):1047-51

[emed-14] Lanigan, Michael (September 27, 2012). "Pilonidal Cyst and Sinus". Medscape. WebMD. Retrieved February 8, 2013.

[ispub-15] Saad, Saad; Shakov, Emil; Sebastian, Vinod; Saad, Adam (2007). "The use of Wound Vacuum-assisted Closure (V.A.C.™) system in the treatment of Recurrent or Complex Pilonidal Cyst Disease: Experience in 4 Adolescent Patients". The Internet Journal of Surgery 11 (1). doi:10.5580/382. ISSN 1528-8242. |accessdate= requires |url= (help)

[16] Hodges, RM (1880). "Pilonidal sinus". The Boston Medical and Surgical Journal 103: 485–586.

[isbn-3-540-64046-0-17] Kanerva 2000, p. 821

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案内

pilonidal sinus