COCCYGEAL FISTULAE

Coccygeal pits.

BACKGROUND Congenital dermal sinuses represent cutaneous depressions or tracts that are lined by stratified squamous epithelium. They communicate between the surface of the skin and deeper structures and may occur anywhere along the craniospinal axis. These sinuses are thought to result from abnormal separation of the cutaneous and neural ectoderm between the third and fifth week of intrauterin...

Isolated coccygeal tuberculosis.

A 47-year old female presented with a purulent discharge per anum for 14 months. During examination under anaesthesia a ‘sinus’ was found extending from six o’clock position at dentate line into the post-anal space. The primary opening was at the upper end of a fissure-in-ano (Figure 1). She underwent exploration of the post-anal space where a partially destroyed coccyx was found in an ‘abscess...

Isolated Coccygeal Tuberculosis

Isolated tuberculosis of the coccyx is extremely rare. A 35-year-old man presented with a 3-month history of coccygeal and gluteal pain. Computed tomography and magnetic resonance imaging revealed osseous destruction and a large enhancing mass involving the coccyx with anterior and posterior extension. Pathologic examination of the surgical specimen revealed necrosis, chronic granulomatous infl...

A Sacro-Coccygeal Cyst

GASTROINTESTINAL FISTULAE Optimising the treatment of upper gastrointestinal fistulae

A three stage strategy is generally employed in the management of gastrointestinal fistulae which can form due to surgery, disease, or trauma. The condition is investigated leading to diagnosis, conservative treatment is initiated to stabilise the patient, followed by specific surgical treatment measures in complicated cases, or in the absence of spontaneous closure. Conservative management of ...