Recurring Pilonidal Cyst Issues
Greetings, everyone. I'm a 24-year-old male, standing at 6 feet 2 inches and weighing 226 pounds, currently facing yet another episode with a Pilonidal Cyst. As I share this, I am contending with my third occurrence of this condition. My initial surgical procedure took place in 2018, and the most recent one was in January of this year. This time around, my recovery involved managing an open wound. I diligently followed all recommended recovery practices, including soaking in sitz baths and maintaining frequent hygiene routines. However, by early April, I began to observe fresh bleeding and suspected pus. At that moment, I didn't think too much of it, considering I was still in a period covered by my insurance and presumed my healing was on track. As days passed, the discomfort intensified, and I noticed a troubling mixture of blood and pus accompanied by a strong, unpleasant odor. This increased my concern about possibly facing another cyst recurrence or an infection of some kind. While drafting this post, I find myself at my office dealing with some challenging symptoms: I've been wearing a pad throughout the day due to ongoing bleeding, which emits a foul smell, and I've endured significant pain. Conversations with my colleagues revealed that many had experienced similar issues and advised me to head to the emergency room for immediate treatment. I'm left wondering if this situation constitutes an emergency, especially since I had surgery for this condition just a few months ago. I'm truly exhausted from this ongoing struggle and yearn to live my life without the constant anxiety surrounding this issue. My previous surgery had given me relief for nearly six years, and while I'm aware that Pilonidal Cysts often recur, I sincerely hope for at least a year of freedom from this distress.
Answers (1)
6/23/2025, 10:20:43 PM
OpenHealth AI
It sounds like you’re dealing with a frustrating and painful recurrence of a pilonidal cyst, which can indeed be distressing after having surgical treatment. Given the symptoms you are describing—bleeding, pus, a foul smell, and significant pain—it’s understandable to feel concerned about whether this situation may require immediate medical attention.
Main Points:
- Your symptoms suggest an infection, possibly related to the pilonidal cyst.
- It's critical to seek medical evaluation, especially since your symptoms have worsened.
- Until you can receive care, there are some immediate comfort measures to consider.
Explanation:
Pilonidal cysts occur in the crease between the buttocks and can become infected, leading to the symptoms you're experiencing. Post-surgical complications can sometimes lead to infections or an incomplete healing of the area, resulting in further discomfort and potential recurrence. The presence of bleeding, pus, and a strong odor usually indicates infection, which may require antibiotic treatment or additional intervention.
Next Steps:
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Seek Medical Attention: Given the severity of your symptoms, it is recommended that you visit your healthcare provider or an emergency room as soon as possible. Explain your history with pilonidal cysts and your current symptoms.
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Maintain Hygiene: Until you can see a healthcare provider, keep the area clean and dry. Gently wash with mild soap and water daily, and avoid any strong irritants.
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Comfort Measures: You can take over-the-counter pain relievers, such as ibuprofen or acetaminophen, to help manage pain. If you have access to sitz baths, continuing those can provide some relief, but ensure the area dries thoroughly afterward.
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Monitor Symptoms: Pay attention to any further changes, such as increased redness, swelling, or fever, and inform your healthcare provider about these symptoms during your visit.
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Discuss Long-Term Management: Once you get through this flare-up, consider discussing long-term strategies with your healthcare provider to minimize the risk of recurrence, such as lifestyle changes or potential surgical options tailored to your situation.
I understand this cycle can be very exhausting, and it’s normal to desire a break from these recurrent issues. Receiving timely care and forming a management plan with your provider can help you achieve that. Please take care of yourself, and don't hesitate to seek help promptly.
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - 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7 Months Old) - **Weight:** 9 kg (good growth rate in spite of condition) - **Jaundice:** Continues to be present (yellow skin) - **Stools:** Remain pale/clay-colored - **Development:** Achieving appropriate milestones - **Energy:** Appears to have a good energy level - **Feeding:** Normal appetite --- ## QUESTIONS FOR r/AskDocs We have been informed this is **Type 2 Abernethy malformation** (portal vein present). **Three treatment avenues have been proposed:** ### Option 1: **Endovascular Coil Embolization** (minimally invasive approach) - A catheter is inserted via the leg vein to access the shunt and deploy coils/plugs to close the abnormal vessels - Pros: No surgical incision, minimal discomfort, short hospital stay (2-4 days), no scars, enhanced safety - Duration: 1-2 hours - Recovery: 2-4 weeks for jaundice to show improvement ### Option 2: **Open Surgical Intervention** - An incision in the abdomen to ligate abnormal vessels and redirect blood to the liver - Pros: Direct visualization, effective results - Cons: Surgical scar, longer recovery time (7-14 days in hospital) - Duration: 2-4 hours ### Option 3: **Liver Transplantation** - We have been advised this is not necessary as the portal vein is functional and liver health is improving. --- ## SPECIFIC QUESTIONS TO CONSIDER: 1. **With a functional portal vein (6.1 mm) and improving liver function (ALT normalized), is it advisable to pursue endovascular closure as the preferred treatment?** 2. **Despite ALT levels improving, the bilirubin remains consistently high (242). Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. Seeking expert advice on optimal treatment strategy and timing.