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International Wound Journal Apr 2019The ideal treatment for patients who suffer from pilonidal sinus disease should lead to a cure with a rapid recovery period allowing a return to normal daily activities,... (Review)
Review
The ideal treatment for patients who suffer from pilonidal sinus disease should lead to a cure with a rapid recovery period allowing a return to normal daily activities, with a low level of associated morbidity. A variety of different surgical techniques have been described for the primary treatment of pilonidal sinus disease and current practice remains variable and contentious. Whilst some management options have improved outcomes for some patients, the complications of surgery, particularly related to wound healing, often remain worse than the primary disease. This clinical review aims to provide an update on the management options to guide clinicians involved in the care of patients who suffer from sacrococcygeal pilonidal sinus disease.
Topics: Adult; Aged; Aged, 80 and over; Female; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Pilonidal Sinus; Practice Guidelines as Topic; Sacrococcygeal Region; Surgical Procedures, Operative; Wound Healing
PubMed: 30440104
DOI: 10.1111/iwj.13042 -
BioMed Research International 2017Caudal epidural block is a commonly used technique for surgical anesthesia in children and chronic pain management in adults. It is performed by inserting a needle... (Review)
Review
Caudal epidural block is a commonly used technique for surgical anesthesia in children and chronic pain management in adults. It is performed by inserting a needle through the sacral hiatus to gain entrance into the sacral epidural space. Using conventional blind technique, the failure rate of caudal epidural block in adults is high even in experienced hands. This high failure rate could be attributed to anatomic variations that make locating sacral hiatus difficult. With the advent of fluoroscopy and ultrasound in guiding needle placement, the success rate of caudal epidural block has been markedly improved. Although fluoroscopy is still considered the gold standard when performing caudal epidural injection, ultrasonography has been demonstrated to be highly effective in accurately guiding the needle entering the caudal epidural space and produce comparative treatment outcome as fluoroscopy. Except intravascular and intrathecal injection, ultrasonography could be as effective as fluoroscopy in preventing complications during caudal epidural injection. The relevant anatomy and techniques in performing the caudal epidural block will be briefly reviewed in this article.
Topics: Adult; Anesthesia, Caudal; Anesthesia, Epidural; Child; Epidural Space; Humans; Injections, Epidural; Low Back Pain; Sacrococcygeal Region; Sciatica; Ultrasonography
PubMed: 28337460
DOI: 10.1155/2017/9217145 -
African Journal of Paediatric Surgery :... 2022Rhabdomyosarcoma (RMS) is one of the common malignant soft-tissue sarcomas affecting children. It originates from the embryonic mesenchyme precursor of striated muscle...
Rhabdomyosarcoma (RMS) is one of the common malignant soft-tissue sarcomas affecting children. It originates from the embryonic mesenchyme precursor of striated muscle and is frequently seen in the head-and-neck region, genitourinary system and extremities. Occasionally, it arises from the retroperitoneum, biliary tract and abdomen and is rarely seen in the sacrococcygeal area. A 4-month-male child presented with a nodule over the sacrum. Based on histopathology and immunohistochemical marker studies, a final diagnosis of RMS was rendered. There was no evidence of any teratomatous elements.
Topics: Child; Humans; Male; Rhabdomyosarcoma; Sacrococcygeal Region; Soft Tissue Neoplasms; Teratoma
PubMed: 36018208
DOI: 10.4103/ajps.ajps_69_21 -
Medicine Dec 2022Sacrococcygeal teratomas (SCT) in adults are extremely rare, and most SCTs are located either mainly outside the pelvis, with a small number of intrapelvic components,... (Review)
Review
Sacrococcygeal teratomas (SCT) in adults are extremely rare, and most SCTs are located either mainly outside the pelvis, with a small number of intrapelvic components, or mostly in the pelvis (types III and IV). The etiology of teratomas remains unknown. Most teratomas are benign, and approximately 1 to 2% of teratomas undergo malignant transformation, including squamous cell carcinoma, adenocarcinoma, sarcoma, and other malignancies. Most SCTs grow insidiously, and their symptoms are not easily detected in the early stages. Some cases may only be discovered through physical examination or compression symptoms when the tumor reaches a detectable size. Computed tomography and magnetic resonance imaging have high detection rates for presacral space-occupying lesions and can provide imaging details with guiding significance for the selection of surgical methods. Surgical resection is the preferred treatment option for SCT and can determine the pathological type. Common sacrococcygeal malignancies are mainly immature teratomas and mature teratomas. When the presence of malignant components is confirmed, the treatment model should be adjusted according to pathological type.
Topics: Humans; Adult; Sacrococcygeal Region; Teratoma; Tomography, X-Ray Computed; Pelvic Neoplasms; Pelvis; Spinal Neoplasms
PubMed: 36596010
DOI: 10.1097/MD.0000000000032410 -
Archives of Pathology & Laboratory... Jul 2019Skin tags are fairly common lesions usually seen in adults on the neck and in body folds. The sacrococcygeal region is an unusual location for skin tags in children and... (Review)
Review
Skin tags are fairly common lesions usually seen in adults on the neck and in body folds. The sacrococcygeal region is an unusual location for skin tags in children and may represent a congenital malformation of the spine or an isolated skin lesion. In this review, we summarize the clinical presentation, histopathologic changes, and differential diagnosis of coccygeal polypoid eccrine nevus as a rare cause of sacrococcygeal papules in children.
Topics: Eccrine Glands; Hamartoma; Humans; Sacrococcygeal Region; Skin Diseases
PubMed: 30605023
DOI: 10.5858/arpa.2018-0055-RS -
Clinical Autonomic Research : Official... Feb 2018We recently defined genetic traits that distinguish sympathetic from parasympathetic neurons, both preganglionic and ganglionic (Espinosa-Medina et al., Science... (Review)
Review
We recently defined genetic traits that distinguish sympathetic from parasympathetic neurons, both preganglionic and ganglionic (Espinosa-Medina et al., Science 354:893-897, 2016). By this set of criteria, we found that the sacral autonomic outflow is sympathetic, not parasympathetic as has been thought for more than a century. Proposing such a belated shift in perspective begs the question why the new criterion (cell types defined by their genetic make-up and dependencies) should be favored over the anatomical, physiological and pharmacological considerations of long ago that inspired the "parasympathetic" classification. After a brief reminder of the former, we expound the weaknesses of the latter and argue that the novel genetic definition helps integrating neglected anatomical and physiological observations and clearing the path for future research.
Topics: Ganglia, Parasympathetic; Ganglia, Sympathetic; Humans; Sacrococcygeal Region; Spinal Cord
PubMed: 29103139
DOI: 10.1007/s10286-017-0478-7 -
CMAJ : Canadian Medical Association... Nov 2015
Topics: Adult; Hidradenitis Suppurativa; Humans; Male; Sacrococcygeal Region
PubMed: 26261194
DOI: 10.1503/cmaj.150018 -
Spinal Cord Series and Cases 2020Sacral reflexes are important to allow the SCI practitioner to gain information about the state of the sacral spinal cord segments. The presence of the bulbocavernosus... (Review)
Review
Sacral reflexes are important to allow the SCI practitioner to gain information about the state of the sacral spinal cord segments. The presence of the bulbocavernosus and/or the anal wink reflex indicate an intact spinal reflex arc and reflex conal autonomic function (as part of the upper motor neuron syndrome); their absence defines a lower motor neuron syndrome. The assessment of sacral reflexes helps predict the type of bladder, bowel and sexual functions and the related therapeutic interventions. We suggest adding the sacral component of the International Standards for the Assessment of Autonomic Function after SCI (ISAFSCI) to the International Standards for the Neurologic Classification of Spinal Cord Injury (ISNCSCI) examination so there can be a detailed description of these important functions. As an alternative, the performance of sacral reflexes should be routinely required as part of the neurologic examination after SCI. Whether the sacral motor neuron system is classified as upper or lower motor neuron injury is also quite useful and as such should be present in the ISCNSCI.
Topics: Humans; Neurologic Examination; Reflex; Sacrococcygeal Region; Spinal Cord Injuries
PubMed: 31934355
DOI: 10.1038/s41394-019-0252-2 -
Neurology Sep 2013A 23-year-old man with recurrent acute myeloid leukemia (AML) underwent successful reinduction and was judged posttherapy to be in complete remission. Soon thereafter,...
A 23-year-old man with recurrent acute myeloid leukemia (AML) underwent successful reinduction and was judged posttherapy to be in complete remission. Soon thereafter, he complained of pain in his left buttock radiating into his left posterior thigh. Neurologic examination was unremarkable. Radiographic evaluation demonstrated a left S2 lesion suggestive of a nerve sheath tumor (figure 1). An open biopsy was performed that revealed a chloroma pathologically (figure 2), sometimes referred to as a myeloid sarcoma.(1,2) Most chloromas are found in patients with recurrent AML and are overwhelmingly intracranial.(1) Infrequently, chloromas are paraspinal, and in this location present with epidural spinal cord compression.(2) Intraspinal invasion by a chloroma is rare. Systemic evaluation confirmed recurrent AML, for which he was successfully treated with reinduction and whole-body irradiation followed by an allogeneic transplant. He is currently disease-free and neurologically asymptomatic 1 year posttransplant.
Topics: Humans; Magnetic Resonance Imaging; Male; Nerve Sheath Neoplasms; Neurologic Examination; Sacrococcygeal Region; Sacrum; Sarcoma, Myeloid; Spinal Cord Compression; Spinal Neoplasms; Tomography, X-Ray Computed; Young Adult
PubMed: 24019392
DOI: 10.1212/WNL.0b013e3182a43aed -
CA: a Cancer Journal For Clinicians 1988
Review
Topics: Age Factors; Child; Combined Modality Therapy; Female; Follow-Up Studies; Humans; Infant, Newborn; Male; Prognosis; Sacrococcygeal Region; Teratoma
PubMed: 3141009
DOI: 10.3322/canjclin.38.6.362