Enfermedad de Pilonidal

La enfermedad pilonidal es una infección crónica de la piel en el pliegue de las nalgas cerca del cóccix (coxis). Es más común en los hombres que las mujeres y ocurre con mayor frecuencia entre la pubertad y la edad de 40 años. La obesidad y el pelo grueso y rígido del cuerpo hacen a las personas más propensas a la enfermedad pilonidal.

La enfermedad pilonidal afecta el área de las nalgas. Se muestran dos pequeñas aberturas.

CAUSAS

Los pelos a menudo crecen en la hendidura entre las nalgas. Estos folículos pilosos pueden infectarse. Además, el cabello puede ser atraído hacia estos abscesos empeorando el problema.

SÍNTOMAS

Los síntomas pueden variar de muy leve a severo. Los síntomas pueden incluir:

  • Pequeño hoyuelo
  • Masa dolorosa grande
  • Drenaje líquido, nublado o sangriento del área afectada
  • Si está infectado, el área se vuelve roja y tierna y el drenaje (pus) huele mal
  • Si está infectado, puede tener fiebre, náusea o sentirse enfermo

MODELOS DE ENFERMEDAD

Casi todos los pacientes tienen un episodio de absceso agudo (el área está hinchada, tierna y pus puede drenar de ella). Después de que el absceso se va, ya sea por sí mismo o con atención médica, muchos pacientes desarrollan una cavidad pilonidal. Es una cavidad debajo de la superficie de la piel que se conecta a la superficie a través de una o más aberturas pequeñas. Algunos tractos sinusales pueden resolver por sí mismos, sin embargo, la mayoría de los pacientes necesitan una cirugía menor para eliminarlos.

DIAGNÓSTICO

El diagnóstico suele ser confirmado por un médico que examina el área de la nalga.

TRATAMIENTO

El tratamiento depende del modelo de enfermedad. El tratamiento primario para un absceso agudo es el drenaje. Se realiza una incisión que permite el drenaje del pus, reduciendo la inflamación y el dolor. Este procedimiento generalmente se puede realizar en la consulta de un médico bajo anestesia local.

TRATAMIENTO QUIRÚRGICO

Las infecciones complejas o recurrentes deben ser tratadas quirúrgicamente, ya sea por escisión o apertura de las cavidades sinusales. Descubrir las cavidades, como se muestra en la Figura 2, implica abrir el absceso y los tractos y recortar los bordes de la piel.

La inflamación localizada profundamente bajo la piel por encima del cóccix. La línea discontinua indica el área que se va a abrir o no. La línea discontinua en el dibujo C muestra todo el tejido inflamado que se eliminará.

Operaciones más amplias y abiertas suelen dar como resultado mejores resultados, aunque la cicatrización tarda más. El cierre con solapas tiene un mayor riesgo de infección, pero puede ser necesario en algunos pacientes. Su cirujano de colon y recto discutirá todas las opciones y le ayudará a elegir la cirugía más adecuada.

PROGNOSIS POSQUIRÚRGICA

Cuando la herida está cerrada, debe mantenerse limpia y seca hasta que la piel esté completamente curada. Si la herida se deja abierta, los apósitos o el empaque se utilizan para ayudar a eliminar las secreciones y permitir que el área se cure de abajo hacia arriba.

Después de la curación, la piel en el pliegue de las nalgas debe mantenerse limpia y libre de pelo. Es necesario afeitarse o usar un agente de depilación cada 2 o 3 semanas hasta la edad de 30. Después de esa edad, los cabellos se diluyen y se suavizan y la profundidad de la hendidura de la nalga disminuye. La enfermedad de Pilonidal puede ser una condición crónica y recurrente así que es importante seguir las instrucciones de cuidado médico postquirúrgico de su médico.

¿QUÉ ES UN CIRUJANO DE COLON Y RECTO?

Cirujanos de colon y recto son expertos en el tratamiento quirúrgico y no quirúrgico de las enfermedades del colon, recto y ano. Han completado el entrenamiento quirúrgico avanzado en el tratamiento de estas enfermedades, así como la formación en cirugía general completa. Cirujanos certificados por la junta de colon y recto completan residencias en cirugía general y cirugía de colon y recto, y pasan los exámenes intensivos llevados a cabo por la Junta Americana de Cirugía y la Junta Americana de Cirugía de Colon y Recto. Ellos están bien versados en el tratamiento de enfermedades tanto benignas como malignas del colon, recto y ano. Ellos son capaces de realizar exámenes de detección rutinas y de tratar quirúrgicamente condiciones, si está indicado para hacerlo.

AVISO LEGAL

La Asociación Americana de Cirujanos de Colon y Recto está dedicada a asegurar la atención al paciente de alta calidad, al avance de la ciencia, la prevención y el tratamiento de los trastornos y enfermedades del colon, recto y ano.  El propósito de estos folletos es proporcionar información sobre los procesos de enfermedades, y no la de indicar una forma específica de tratamiento. Están diseñados para el uso de  los médicos, trabajadores sanitarios y pacientes que deseen información sobre la gestión de las condiciones tratadas. Estos folletos no incluyen o excluyen otros métodos apropiados de atención médica de estas enfermedades. La última palabra sobre el tratamiento a seguir le corresponde al médico basándose en las circunstancias  de cada paciente.



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