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sinus tract

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GLOSSARY ENTRY (DERIVED FROM QUESTION BELOW)
English term or phrase:sinus tract
English translation:See explanation:
Entered by: chopra_2002
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09:38 Mar 7, 2004
English to English translations [PRO]
Medical - Medical: Health Care / diabetic foot disease
English term or phrase: sinus tract
diabetic foot
alex
See explanation:
Explanation:
Sinus tract,
an abnormal channel leading from within bones or other structures to the skin surface; sometimes this type of passageway is termed a fistula.
Sinus tracts may form after an infection or as a means of decompression of a synovial joint in rheumatoid arthritis or classic fistulous rheumatism.

In septic arthritis, MR imaging may reveal abnormalities such as fluid-filled channels, sinus tracts and fistulae.

Sinography represent a diagnostic imaging method involving opacification of a sinus tract, which may provide information that influences the choice of therapy. Concomitant CT scanning may lead to better delineation of the sinus tract. Sinography in association with fluoroscopy is also employed in evaluation of pressure sores when extent of bone infection is uncertain



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Note added at 2004-03-07 09:57:30 (GMT)
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. A sinus tract is an abnormal channel that originates or ends in one opening. An orofacial fistula is a pathologic communication between the cutaneous surface of the face and the oral cavity.
In the literature, the terms fistulas and sinuses are often used interchangeably. Stedman’s Medical Dictionary defines a sinus as a fistula or tract leading to a suppurating cavity. Orofacial fistulas are not common, but intraoral sinus tracts due to dental infections are common. When infection or neoplasia is involved, immediate treatment is necessary. Dental infections, salivary gland lesions, neoplasms, and developmental lesions cause oral cutaneous fistulas, fistulas of the neck, and intraoral fistulas.

http://www.emedicine.com/derm/byname/oral-cutaneous-fistulas...


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Note added at 2004-03-07 10:59:59 (GMT)
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A \"sinus\" or \"sinus tract\" is a narrow connection from a deep infection to the skin. What happens is that a deep infection develops -- be it from appendicitis, a localized bowel infection or another source. The body contains the infection, preventing it from entering the bloodstream. An abscess (collection of pus) develops that is weaker in one area. As the abscess continues to progresses, a narrow tract forms in the weak area. Eventually, the tract reaches the skin, where it ruptures. Since the pressure of the abscess is relieved, the patient may not have any fever or other general complaints. This is exactly the way chronic osteomyelitis would present. An infection in a long bone develops and progresses, sometimes over months. Eventually the infection reaches the skin, forming a sinus.

A sinus tract developing in the abdomen could have a few causes. It may be due to a deep skin infection. This is possible in your case if you had a retained a surgical suture (stitch) that somehow became infected. There may have been an infection around the suture, just an inch or so beneath the skin. This could have easily progressed to the surface, causing a sinus tract.

The other possibility is a deep abdominal infection. An infection related to your appendix would be unusual given the delay between the surgery and your current problem. I cannot discount the possibility, but I think a second source may be just as likely. One bacterial cause of a much-delayed sinus forming in the abdomen is actinomycosis. This infection, caused by bacteria called Actinomyces, presents very slowly, sometimes more like a tumor. It causes jaw infections after dental abscesses, lung infections and chest sinuses, and abdominal and pelvic infections. Months and occasionally years after a disruption of the bowel, as can occur with a ruptured appendix, the patient can develop a sinus tract to the skin. Fever, abdominal pain and weight loss can all occur.

Treatment of a sinus tract usually requires drainage of the deep infection and surgery to remove the tract. In the uncommon cases of actinomycosis, antibiotics alone for prolonged periods may be sufficient. In your case, I would have the organisms in the pus cultured (grown in the lab) to rule out actinomycosis. If you do not respond to the short course of antibiotics, I would consider a CT scan of your abdomen to make sure there is no deeper infection.

http://www.ivillagehealth.com/print/0,,172331,00.html?arriva...
Selected response from:

chopra_2002
India
Local time: 12:16
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Graded automatically based on peer agreement.
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Summary of answers provided
3 +7See explanation:
chopra_2002


  

Answers


3 mins   confidence: Answerer confidence 3/5Answerer confidence 3/5 peer agreement (net): +7
See explanation:


Explanation:
Sinus tract,
an abnormal channel leading from within bones or other structures to the skin surface; sometimes this type of passageway is termed a fistula.
Sinus tracts may form after an infection or as a means of decompression of a synovial joint in rheumatoid arthritis or classic fistulous rheumatism.

In septic arthritis, MR imaging may reveal abnormalities such as fluid-filled channels, sinus tracts and fistulae.

Sinography represent a diagnostic imaging method involving opacification of a sinus tract, which may provide information that influences the choice of therapy. Concomitant CT scanning may lead to better delineation of the sinus tract. Sinography in association with fluoroscopy is also employed in evaluation of pressure sores when extent of bone infection is uncertain



--------------------------------------------------
Note added at 2004-03-07 09:57:30 (GMT)
--------------------------------------------------

. A sinus tract is an abnormal channel that originates or ends in one opening. An orofacial fistula is a pathologic communication between the cutaneous surface of the face and the oral cavity.
In the literature, the terms fistulas and sinuses are often used interchangeably. Stedman’s Medical Dictionary defines a sinus as a fistula or tract leading to a suppurating cavity. Orofacial fistulas are not common, but intraoral sinus tracts due to dental infections are common. When infection or neoplasia is involved, immediate treatment is necessary. Dental infections, salivary gland lesions, neoplasms, and developmental lesions cause oral cutaneous fistulas, fistulas of the neck, and intraoral fistulas.

http://www.emedicine.com/derm/byname/oral-cutaneous-fistulas...


--------------------------------------------------
Note added at 2004-03-07 10:59:59 (GMT)
--------------------------------------------------

A \"sinus\" or \"sinus tract\" is a narrow connection from a deep infection to the skin. What happens is that a deep infection develops -- be it from appendicitis, a localized bowel infection or another source. The body contains the infection, preventing it from entering the bloodstream. An abscess (collection of pus) develops that is weaker in one area. As the abscess continues to progresses, a narrow tract forms in the weak area. Eventually, the tract reaches the skin, where it ruptures. Since the pressure of the abscess is relieved, the patient may not have any fever or other general complaints. This is exactly the way chronic osteomyelitis would present. An infection in a long bone develops and progresses, sometimes over months. Eventually the infection reaches the skin, forming a sinus.

A sinus tract developing in the abdomen could have a few causes. It may be due to a deep skin infection. This is possible in your case if you had a retained a surgical suture (stitch) that somehow became infected. There may have been an infection around the suture, just an inch or so beneath the skin. This could have easily progressed to the surface, causing a sinus tract.

The other possibility is a deep abdominal infection. An infection related to your appendix would be unusual given the delay between the surgery and your current problem. I cannot discount the possibility, but I think a second source may be just as likely. One bacterial cause of a much-delayed sinus forming in the abdomen is actinomycosis. This infection, caused by bacteria called Actinomyces, presents very slowly, sometimes more like a tumor. It causes jaw infections after dental abscesses, lung infections and chest sinuses, and abdominal and pelvic infections. Months and occasionally years after a disruption of the bowel, as can occur with a ruptured appendix, the patient can develop a sinus tract to the skin. Fever, abdominal pain and weight loss can all occur.

Treatment of a sinus tract usually requires drainage of the deep infection and surgery to remove the tract. In the uncommon cases of actinomycosis, antibiotics alone for prolonged periods may be sufficient. In your case, I would have the organisms in the pus cultured (grown in the lab) to rule out actinomycosis. If you do not respond to the short course of antibiotics, I would consider a CT scan of your abdomen to make sure there is no deeper infection.

http://www.ivillagehealth.com/print/0,,172331,00.html?arriva...



    Reference: http://www.amershamhealth.com/medcyclopaedia/Volume%20III%20...
chopra_2002
India
Local time: 12:16
Specializes in field
Native speaker of: Native in HindiHindi
PRO pts in category: 4
Grading comment
Graded automatically based on peer agreement.

Peer comments on this answer (and responses from the answerer)
agree  Martinique
7 mins

agree  Vicky Papaprodromou
47 mins

agree  mk_lab
1 hr

agree  Rusinterp
1 hr

agree  Nina Engberg
2 hrs

agree  Hacene
4 hrs

agree  Jörgen Slet
21 hrs
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