Abdominal Sinus – Pandora's Box
Creators
- 1. General Surgery Department, TNMC and BYL Nair Charitable Hospital, Mumbai
- 2. Associate Professor, General Surgery Department, TNMC and BYL Nair Charitable Hospital, Mumbai
- 3. Senior Resident, General Surgery Department, TNMC and BYL Nair Charitable Hospital, Mumbai
Description
Sinus tract is a blind tract lined by granulation tissue leading from an epithelial surface into the surrounding tissue. Retained foreign body is one of the cause which can also lead to sepsis, intra-abdominal abscess and fistula. The sinus tract can involve the intestine as well as other hollow organs to form fistula if untreated, therefore early diagnosis and treatments important. Chronic sinuses are more commonly seen in head and neck, sinus tract formation following pelvic surgeries for uterine prolapse are rare. A 40 year old female presented with discharge from sinus opening in right iliac fossa since 2 yrs, with a past history of 4 times surgeries for uterine prolapse via abdominal and vaginal approach 16yrs back. Sinogram suggestive of linear blind ending sinus tract of length 2cm and CECT of abdomen and pelvis revealed the linear sinus tract arising from anterior abdominal wall in right iliac fossa showing intraperitoneal extension encircling the rectus abdominis muscles. Patient underwent sinus tract excision with finding been a 6cm long sinus tract extending up to the rectus with mersilene tape as its content. It is crucial to accurately assess the depth and extent of sinus invasion and fistula formation before treatment for personalized treatment plans.
Abstract (English)
Sinus tract is a blind tract lined by granulation tissue leading from an epithelial surface into the surrounding tissue. Retained foreign body is one of the cause which can also lead to sepsis, intra-abdominal abscess and fistula. The sinus tract can involve the intestine as well as other hollow organs to form fistula if untreated, therefore early diagnosis and treatments important. Chronic sinuses are more commonly seen in head and neck, sinus tract formation following pelvic surgeries for uterine prolapse are rare. A 40 year old female presented with discharge from sinus opening in right iliac fossa since 2 yrs, with a past history of 4 times surgeries for uterine prolapse via abdominal and vaginal approach 16yrs back. Sinogram suggestive of linear blind ending sinus tract of length 2cm and CECT of abdomen and pelvis revealed the linear sinus tract arising from anterior abdominal wall in right iliac fossa showing intraperitoneal extension encircling the rectus abdominis muscles. Patient underwent sinus tract excision with finding been a 6cm long sinus tract extending up to the rectus with mersilene tape as its content. It is crucial to accurately assess the depth and extent of sinus invasion and fistula formation before treatment for personalized treatment plans.
Files
IJPCR,Vol15,Issue4,Article112.pdf
Files
(1.9 MB)
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Additional details
Dates
- Accepted
-
2023-04-15
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue4,Article112.pdf
- Development Status
- Active
References
- 1. Du, X., Yan, Y., Sun, P. et al. Value of CT sinography and analysis of missed diagnosis and misdiagnosis for abdominal wall sinus. BMC Gastroenterol. 2022; 22: 214. 2. Ghose S, Pallavee P, Samal S, et al. Cotton Umbilical Tape as a Sling: Case Series. J South Asian Feder Obst Gynae. 2022;14(5):623–624. 3. Wohlrab KJ, Erekson EA, Myers DL. Postoperative erosions of the Mersilene suburethral sling mesh for ant incontinence surgery. Int Urogynecol J Pelvic Floor Dysfunct. 2009 Apr; 20(4):417-20. 4. William.D. Winkelman, Jacques.P. Sasson, Eman Elkadry, A novel approach to identification and excision of a persistent sinus tract following a rectus fascial sling: A case report, Case Reports in Women's Health, 2021; 31: e00333, 5. Shrestha B, Hampton J. Intraabdominal abscess and intractable sinus - a rare late complication after splenectomy. World J Clin Cases. 2017 Jan 16;5(1):14-17.