Home / Diseases of the soft tissues of the back: causes, diagnosis, methods of therapy / Pineal of education and the seal in the region of the sacrococcygeal region

Pineal of education and the seal in the region of the sacrococcygeal region

Sometimes patients at a reception at the surgeon can complain of any education in the skin sacrococcygeal region (the"bumps" on the coccyx). This may be supplemented by complaints of redness, swelling in the coccyx area and the presence of purulent discharge. As a rule, in this case, the formation of the Sacro-coccygeal region is very sore. There are several main causes of formation of "lumps" in the area of the coccyx.

  1. trauma to the sacrococcygeal region. Banal bruised tailbone may seem like "lump" and not always accompanied by the formation of a hematoma (bruise) in this area. After the fracture may grow excess bone tissue at the site of callus formation. It is important to link the appearance of "bumps" that seals in the coccyx region with the presence or absence of injury.
  2. Epithelial coccygeal course (ECX, pilonidal sinus, coccygeal epithelial cyst). More commonly found in children and in younger men (under 35 years). In women may occur, but less frequently. Pilonidal sinus is a kind of atavism, a remnant of the caudal part of the embryo.

being asymptomatic course of the disease does not manifest itself, on closer inspection it is only possible to detect the distal hole ECX just above the anus on the midline of the body. The stage of infiltration occurs blockage of the waste products of stratified epithelium and glands inside ECX. Then there tyazhistye, painless lump in the buttock crease, near or directly on the midline of the body. To the coccyx the seal (infiltration, "bump") is located below, i.e., below the coccyx.

Epithelial coccygeal passage in the stage of infiltration

figure 1 – epithelial coccygeal passage in the stage of infiltration

With the further development of the inflammatory response may form an abscess (the acute phase) or tracts (chronic inflammatory process). Abscess ECX appears soreness of the zone as on palpation and while walking, sitting, redness, infiltration, swelling of the surrounding tissue and increasing body temperature.

stage of abscess in acute inflammation ECX

figure 2 – the stage of abscess in acute inflammation ECX

After the formation of the fistulous content of epithelial coccygeal cyst (pus, pus) arises on the skin surface, the inflammation subside. Such cycles "infiltration-abscess-breakthrough-liberation through the fistula (tunnels)" without adequate treatment there can be any number.

Chronic ECX

figure 3 – chronic ECX

Treatment with surgery alone, some methods of conservative treatment are used for preparation of the patient for a planned surgical intervention.Read more about diagnosis and treatment of epithelial coccygeal progress can be read here.

  1. Gidradenity the coccyx area. Due to the localization of sweat glands of the perianal area can easily become infected, inflammation of the sweat glands and has called.
Localization of apocrine sweat glands

figure 3 – localization of apocrine sweat glands

How it will look hydradenitis? In the perianal area (between the anus and coccyx) is the small focus of inflammation with clear contours, rounded shape, redness, swelling, sharp pain with pressure. Alone in the zone of inflammation also pain is felt. Such lesions may be multiple, if the inflammatory process involved multiple apocrine sweat glands.

The Treatment has, as a rule, surgical, and consists in opening and draining the abscess. After surgery use of antibiotic, anti-inflammatory therapy, autohaemotherapy, physiotherapy.


figure 4 – hydradenitis

  1. sebaceous cyst – tumor-like formation of the skin that may occur due to blockage of sebaceous gland duct (see figure 3 for the location of the sebaceous glands in the skin). Favourite places of localization of the scalp, face, coccyx area where there are many sebaceous glands.

Atheroma is a painless rounded education in the area of the coccyx, have thicker skin and are easily movable along with it, often like a small ball on the touch. Can be located on the midline of the body or near it, often just below the tailbone or level it and the Sacro-coccygeal articulation. It grows slowly, long maintained without suppuration (see figure 5).

sebaceous cyst neck

picture 5 – sebaceous cyst of the neck

Average size of from 1 to 4 cm, Sometimes in the center you can see the extended duct of the sebaceous gland (figure 6). When suppuration the size of the atheromas grow, the skin color changes to a reddish-cyanotic, increases tissue swelling, pain with pressure alone. More pronounced becomesthe clogged lumen of the duct of the gland.

unlike the ECX suppuration atheroma is optional, it may long exist, without causing any discomfort. Its treatment is surgical tactics and volume of surgical intervention depend on the stage of the disease.

Festering atheroma

figure 6 – the festering atheroma

  1. Dermoid cyst of the coccygeal region.

Teratomas are embryonal tumors containing various kinds of fabrics, and can be Mature, immature and with malignant degeneration. Their dimensions are variable. A large portion of Mature teratoma formation is dermoid cysts, which are embryonic benign cystic tumor-like formations, definitely a capsule and usually contain hair and glandular elements, skin flakes, teeth.

Teratoma containing hair, teeth

figure 7 – teratoma, containing hair and teeth

Immature teratomas are formed from cells of embryonic tissues and are poorly differentiated and therefore potentially malignant. Dermoid cysts and teratomas often found in children or in young age they can be long not to give clinical symptoms until their size becomes significantly large. The size of teratoma formation are variable: from small (3 cm) to a giant, the contours of clear (due to the presence of the capsules), but the shape is generally irregular.

The incidence of teratoma formation 1 in 40 000 newborns. The clinic will be determined by their place of localization in the sacrococcygeal region. Often, the first symptoms, besides the presence of vbuhanie on the skin, are impaired bowel movement, prolonged constipation, difficulty urinating, presence of spider veins on the sacrum (the symptoms of compression, the formation of vascular anastomoses).

Confirmation of the diagnosis it is possible after a CT scan, MRI of the field, radiography of sacrococcygeal Department in two projections, pelvic ultrasound. Treatment only surgical as possible in a shorter time because of the possibility of malignancy of embryonal tumors.

Huge teratoma in a child

figure 8 – a huge teratoma in a child

  1. Chordoma of the sacrum. Rare formations also include chordoma the tumor from remnants of the notochord of human embryos. One of the authors believes it is malignant, the other benign with possibility of malignancy. The usual localization – cranial or sacral. The sacrum may be up to 50% of all hardom.
Schematic representation of chordoma of the sacrum

figure 9 – schematic representation of chordoma of the sacrum

The Disease usually develops in middle-aged (about 50 years). More often men suffer from. The symptoms are due to the localization process.

The Growth of the tumor usually occurs posteriorly, breaking the vertebrae and causing bulging in the sacrococcygeal region. In addition to the formation of irregularly shaped, often large in size, you experience the following symptoms: pain in the sacrum, radiating to the lower limbs, groin, impaired function of the pelvic organs, violation of sensitivity in the anal region (the radicular syndrome).

For diagnosis is digital rectal examination (it is possible to palpate a part of the tumor), radiography in two projections, ultrasound of the pelvic organs and be sure to CT or MRI. Only the last two methods can give a complete picture of the size and location of the tumor.

The Treatment is only surgical. The sooner chordoma is detected, the higher the probability to avoid relapses of malignancy.

CT scan of the sacrum

figure 9 – CT scan of the sacrum, chordoma in the form of "cauliflower"

  1. spina bifida and degenerative disc disease in the lumbar, lumbosacral, and other degenerative and inflammatory diseases of the spine may provoke the development of strain in the Sacro-coccygeal region. In this case, the education is dense to the touch almost like a bone, not movable together with the skin. The x-ray, MRI, CT scan revealed hardening in sacral-coccygeal region.

Thus, if in the sacrococcygeal region appeared pineal education, any growth, in the first place should evaluate its own state:

  1. injury to the coccyx area, fall on the buttocks? How long?
  2. When did it come? If associated with profuse sweating and exercising?
  3. If the injury was not rate, what is this mass: dense or loose, what color, what size, whether there are holes, concrete place. How deep is it? If shifting from the skin easily, as though rolled under the fingers, it is an intradermal location, if not, then most likely originates from the formation of bone structures, soft tissues, cellulose.
  4. Pain syndrome is present or not, when pressed, alone, walking, sitting.

With any education, especially in the absence of pain, you should consultsurgeon for examination and differential diagnosis. Many inflammatory diseases of the coccyx region, accompanied by the formation of "bumps", it is best to operate in the cold stage, it is less traumatic intervention with shorter recovery.