Johnson Shepard P, Kaoutzanis Christodoulos, Schaub George A
Department of General Surgery, Saint Joseph Mercy Health System, Ann Arbor, Michigan, USA.
BMJ Case Rep. 2014 Apr 4;2014:bcr2013201922. doi: 10.1136/bcr-2013-201922.
Subareolar abscess of the male breast is a rare condition, which can be complicated by a fistula from the areolar skin into a lactiferous duct. In 1951, Zuska et al first characterised this entity in women. Literature on mammillary fistulas in men is scarce and therefore standardisation of treatment does not exist. We present two cases of recurrent subareolar abscesses with draining fistulas. Both patients were successfully treated by complete excision of the lactiferous duct fistula, and continue to do well with no evidence of disease recurrence. When male patients present with a draining subareolar abscess, one should have a high index of suspicion for a mammillary fistula. Failure to identify and surgically excise the fistula may lead to recurrence of the abscess and prolonged morbidity. The most effective management of this uncommon entity includes complete excision of the lactiferous duct fistula.
男性乳晕下脓肿是一种罕见疾病，可并发乳晕皮肤至输乳管的瘘管。1951年，祖斯卡等人首次在女性中描述了这种病症。关于男性乳头瘘的文献很少，因此不存在标准化的治疗方法。我们报告两例复发性乳晕下脓肿伴引流瘘管的病例。两名患者均通过完整切除输乳管瘘管成功治愈，且目前病情良好，无疾病复发迹象。当男性患者出现乳晕下引流脓肿时，应高度怀疑乳头瘘。未能识别并手术切除瘘管可能导致脓肿复发和病程延长。对这种罕见病症最有效的治疗方法包括完整切除输乳管瘘管。
