General & Minimal Access Surgery

A lipoma is a benign (noncancerous) tumour that forms slowly under the skin and is made of fat tissue. The back, torso, arms, shoulders, and neck are the most typically affected areas. It is the most common tumor in the human body. Associated Anatomy This illness is mostly linked to the skin (just beneath the skin, to be precise) but it can occur anywhere in the body. Lipoma Causes Although the actual cause of lipoma is unknown, some cases are thought to be genetic. People who have a family history of lipomas are substantially more likely to develop them. Inherited conditions like Madelung's disease, Cowden syndrome, Adiposis dolorosa, and Gardner's syndrome can increase the likelihood of developing lipomas. Lipoma Symptoms A soft lump of rubbery tissue with a diameter of 2-10 cm It's normally encapsulated or in the shape of an egg, and it doesn't spread to the tissues around it. It's movable - it can be moved under the skin with your fingers. Painless - Lipomas are normally painless, but if they rub on surrounding nerves, they might cause discomfort. Colourless and slow-growing Types & Stages of Lipoma Different types/stages of lipomas include: Conventional lipoma, which has white fat cells and is the most frequent type of lipoma. Hibernoma lipoma contains brown fat, which aids in body temperature regulation. Fibrolipoma is a fat-and-fibrous-tissue tumour. Angiolipoma is made of fat and blood vessels and causes pain. Myelolipoma is a fat-and-tissue tumour that produces blood cells. Spindle cells are fat cells that are rod-shaped. Lipoma Diagnosis Your doctor may do specialised tests to detect a lipoma, such as a physical examination that includes inspecting and feeling the lump. An ultrasound and other imaging tests, such as a magnetic resonance imaging (MRI) scan or a computed tomography (CT) scan, can be used to get a clear view of lipomas. A biopsy may be required to determine if the lipoma is cancerous or non-cancerous by removing a small piece of the lipoma and testing the tissue for cancerous cells. Lipoma Treatment If a lipoma becomes large or causes discomfort or other issues, it can be removed using one of two procedures: Surgery - Lipoma is surgically removed. After an injection to numb the area, a tiny cut is made to remove the lipoma. If it is a small lipoma, large lipoma are removed under general anasthesia. Liposuction to remove fat - Using a specific equipment, a fatty tumour is evacuated through small incisions. There is a chance that the lipoma will reappear after this operation. Risk Factors of Lipoma Several variables can raise the risk of lipoma, including: Age - People in their forties and fifties (40-60 years) are more likely to have this ailment. Genetics - A person with one or more lipomas in their family is more likely to get one. Other diseases - Having several other medical conditions, such as Gardner syndrome, obesity, liver disease, excessive cholesterol, and so on. Lipoma Prevention Primary Prevention Lipomas frequently run in families, suggesting that heredity may play a role. Lipomas cannot be prevented because they are inherited. It can, however, be treated or prevented by reducing the likelihood of developing specific medical disorders including Madelung's disease (by avoiding alcohol use), obesity, liver illness, excessive cholesterol, and so on. Secondary Prevention Get enough rest and avoid putting too much stress and strain on your body. Otherwise, the healing process may be hampered. Eat a well-balanced, healthy diet to ensure enough nutritional levels for the regeneration of damaged tissues. Carefully follow the surgeon's preventive advice and medication guidelines. For 2-3 days, OTC pain relievers such as ibuprofen can help. Check-ins with the surgeon on a regular basis to ensure that you are healing properly. Possible Complication of Lipoma Lipomas do not pose a serious threat to one's health. However, it can expand and become uncomfortable at times. In such cases, the doctor may advise surgical removal of the fatty tissue. Lipomas can induce luminal blockage, bleeding, calcification, and infection in rare cases. Epidemiology of Lipoma Lipomas are prevalent, affecting about one out of every 100 persons (1 percent ). It can emerge at any age, but it is most common between the ages of 40 and 60. People with a history of multiple lipomatosis in their family are more prone to acquire multiple lipomas. It is, however, more usual to develop only one or two. Expected Prognosis of Lipoma There is no risk of malignant transformation in benign lipomas. Lipomas rarely grow again after they've been removed. However, another lipoma could form in a different part of your body. Natural Progression of Lipoma Lipomas are usually harmless and do not interfere with your regular activities. Unless the lipoma is painful, developing or bothering you, there is usually no need for therapy. If you experience these symptoms, your doctor may prescribe surgical removal. Pathophysiology of Lipoma Lipomas have an enigmatic aetiology. Benign lipomas can appear anywhere on the body. A potential for developing lipoma occurs after damage to the affected area, resulting in adipose/fat cell necrosis and subsequent local inflammation. The anatomy is determined by the location of the tumour. Subcutaneous lipomas aren't generally attached to the fascia beneath the skin. To prevent the fibrous capsule from growing back, it must be removed.

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A pilonidal sinus is a minute hole or opening which may also resemble a tube-like structure present in the skin. Sometimes, these openings may be filled with pus or other fluid, forming an abscess or cyst. These occur at the crevice on the upper portion of the hips. Pilonidal cysts often contain dirt, hair, or debris. When infected, it may lead to severe excruciating pain. Once it is infected, pus or blood can be seen oozing out from the site. PNS is a disorder that primarily affects men but is also prevalent among young people. It's also more frequent among people who spend a lot of time sitting, such as cab drivers. Alternate Name of Pilonidal Sinus Pilonidal abscess; Pilonidal disease; Pilonidal cyst. Pilonidal Sinus Causes Although the exact reason for the disease is unknown, certain factors are found related to the occurrence of this condition. These factors include: Hormonal changes as seen in puberty Obesity Hair growth Experience of trauma or irritation Friction caused by clothing or sitting for an extended period When you sit or perform other activities that cause friction, the hair developing in the region can burrow back under the skin. In response to this hair, the body mounts an immune response similar to what it would do to a splinter. When this response occurs, your body produces the cyst surrounding the hair. Many people can have more than one sinus under the skin. Pilonidal Sinus Symptoms The natal cleft, which is the apex of the buttocks crease, right beneath the tailbone, is affected by a pilonidal sinus. Depending on the severity of the illness, symptoms might range from moderate to severe. The common signs and symptoms observed are as follows: Tiny depression in the skin Discomfort Irritation Growth of a painful mass or abscess. The fluid may also contain blood or maybe clear. Tenderness and redness in the area Bad or foul smell Fever Nausea Pilonidal Sinus Diagnosis Sacral osteomyelitis can be misinterpreted as a pilonidal sinus because the sacrum is close to the rectum. Both these conditions have some symptoms in common, such as pain, reddening, and swelling. Other conditions which might be confused with a pilonidal sinus are: Abscess Hidradenitis suppurativa Inflammatory bowel diseases Anal fistula Pilonidal Sinus Treatment The pilonidal sinus treatment plan is based on the type and stage of pilonidal sinus. These are as follows No Symptoms: When you don't show any symptoms of the disease, your physician may advise you to clear any hair if present there. Also, he will advise you to maintain excellent personal hygiene and keep the area as clean as possible. Acute-Onset Condition: When there is a rapid onset of the condition, you may experience pain and pus draining from the area. You will be prescribed pain medication such as Ibuprofen or paracetamol. If needed, a small surgery will be done to drain the pus. Chronic Or Long-Standing Condition With Symptoms: In such cases, mostly surgery is planned. Your physician will discuss all the advantages and complications of the surgery. The surgery will involve an incision at the site of the sinus along with the removal of the infected sinus and the adjacent tissue. This is then left for healing. Depending on your condition, the doctor may decide to leave the wound open or will give a suture for healing. At times, a flap procedure may be required. Pilonidal Sinus Preventions The following steps can be taken to avoid a pilonidal sinus. Washing and drying your buttocks regularly To reduce your risk, you should lose excess weight To keep pressure off the region, avoid sitting for too long The hair surrounding your buttocks should be shaved Possible Complications of Pilonidal Sinus A pilonidal sinus can lead to a variety of problems when left untreated or when the condition recurs even after the surgery has been done. These complications include: Intense pain Swelling and inflammation in the skin Low-grade fever Pus drainage from the site of infection or surgery The foul stench from the wound Poor wound healing Numbness in the wound Bleeding Scarring Allergic reaction and blood clotting In the worst-case scenario, it may lead to osteomyelitis, and skin cancer or bone cancer. Epidemiology of Pilonidal Sinus 26 per 100,000 people. Pilonidal illness is more common in men, with a 3-4:1 male-to-female ratio. It affects mostly Caucasian individuals in their late teens to early twenties, with a decrease after age 25 and a rarity after age 45. Expected Prognosis of Pilonidal Sinus Overall, the prognosis for pilonidal sinus is very good and it hardly causes long-term injury. After treatment, a pilonidal sinus might reappear, but keeping excellent cleanliness practices and eliminating hair from the region will help lessen the chances. Pathophysiology of Pilonidal Sinus The most commonly recognized notion about pilonidal sinus illness is that it begins with an infected or inflamed hair follicle in the crevice area above your buttocks. This inflammation blocks the follicle's entrance, causing it to stretch inwards, leaving a pit or a hole. This may later develop like a tube to form a sinus-like structure.

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