CT Scan Showed Perianal Cysts. MRI Showed Clear. Having Pain. What Does The Reports Says?
You had simple perianal cyst which got complicated. Despite of the advancement in preoperative imaging and surgical techniques, recurrence is not uncommon in this disease entity.
Are you diabetic, when was the last time the screening done? There may be chance of infection during the operation or after the procedure even after following the principles of wound management.
Regarding MRI interpretation, sinus need to be open at the time of scan so that it can be identified. There is another option for diagnosing the complete tract of sinus, SINOGRAM, in which XXXXXX is pushed through sinus opening and x-rays taken , which will delineate the complete track of sinus. Also ask your doctor to do MRI sinography rather than simple MRI, it will be useful. Just go for this last investigation.
A culture and sensitivity of discharge is needed to start antibiotics, as there is no antibiotic in your prescription.
Hope i have cleared your query, feel free to ask anything else.
Thanking you.
Presuming they will now need to open the wound again, what are my options re healing techniques and how many times can it be reasonable to open the same wound (this will be 4 times - 1 last year and 3 within the last 3 months).
Thanks for writing back XXXXXX
I thought it was not diagnosed before on MRI. As per your information it is diagnosed beforehand, so need of sinogram or MRI. Difficult to say but ball is in court of surgeons, either you have to consult another team of surgeons (also radiologist) or ask your specialist for complete sterile conditions for operation.
Regarding healing of wound and reoperation, there is no other option except dedicated dressing and also evaluation of all blood components necessary for healing like blood zinc, vit C level, etc.
Also ask for culture and sensitivity of discharge.
Hope you got your answer.
Thanking you.
I do not have diabetes (not sure of the implications).
Re a new operation - thanks for your suggestion. However, how many times can this site be re-operated on without risk (apart from the obvious - infection).
Your problem is conversion of cyst into sinus. When surgeon opens any wound it’s his job to search the deepness of that wound either by finger or any other instrument. Direct inspection and opening of any wound cannot substitute any other investigation, that’s why I asked you if possible change the team of consultant.
Unfortunately now you have to undergo operative procedure or dressing until wound heals, without any risk, except uncomfortableness.
As there is no other option, I am repeating again to do culture and sensitivity of discharge and then take antibiotics accordingly.
Hope now you are satisfied with my answer.
Thanking you.