Araujo Sabino Edilson, Cavassin Guilherme Pasquini, Santos Juliano Xavier, Borges da Silva João Arthur, Teixeira Henrique Waldraff
General Surgery, Complexo Hospitalar do Trabalhador, Curitiba, BRA.
Medicine, Universidade Federal do Paraná, Curitiba, BRA.
Cureus. 2023 Nov 18;15(11):e49013. doi: 10.7759/cureus.49013. eCollection 2023 Nov.
The sinus tract, a tubular structure with no outlet connecting deep tissues to the skin, is a rare entity, especially in patients undergoing abdominal surgeries. The pathophysiology involves factors such as liquefaction of adipose tissue, infection, and retention of foreign bodies. Inadequate surgical drainage can lead to chronicity, culminating in the formation of an infectious sinus in the abdominal wall, clinically known as a sinus. Understanding this phenomenon is crucial to avoid recurrences and complications. A 65-year-old female patient with a history of multiple abdominal surgeries presented with pain and suprapubic discharge. Similar episodes had occurred previously. Examinations revealed a fistulous tract in the right iliac fossa. The surgical intervention included the excision of the tract, identification of points with cotton thread, and antibiotic therapy. Follow-up in the outpatient setting showed no recurrences. The presence of postoperative foreign bodies, such as sutures, can trigger recurrent local infections. Diagnosis involves imaging studies, and the type of surgical thread influences complications. Treatment aims at drainage and excision of the tract. A multidisciplinary approach is of paramount importance. The sinus, with its insidious formation, highlights the complexity of this condition. Careful selection of surgical materials, precise imaging diagnosis, and a multidisciplinary approach are essential for effective treatment. This case emphasizes the importance of clinical practice to enhance clinical outcomes and the quality of life of patients affected by this challenging condition.
窦道是一种将深部组织与皮肤相连但无出口的管状结构，是一种罕见的情况，尤其是在接受腹部手术的患者中。其病理生理学涉及脂肪组织液化、感染和异物存留等因素。手术引流不充分可导致病情慢性化，最终在腹壁形成感染性窦道，临床上称为窦。了解这一现象对于避免复发和并发症至关重要。一名有多次腹部手术史的65岁女性患者出现疼痛和耻骨上区渗液。之前也曾发生过类似情况。检查发现右髂窝有一条瘘管。手术干预包括切除瘘管、用棉线标记部位以及抗生素治疗。门诊随访未发现复发。术后异物（如缝线）的存在可引发局部反复感染。诊断需要影像学检查，手术缝线的类型会影响并发症。治疗旨在引流和切除瘘管。多学科方法至关重要。窦道形成隐匿，凸显了这种情况的复杂性。仔细选择手术材料、精确的影像学诊断和多学科方法对于有效治疗至关重要。本病例强调了临床实践对于改善受这种具有挑战性疾病影响患者的临床结局和生活质量的重要性。
