4 year old sons possible pilonidal sinus

[Pollyanna80]

Sorry me again. When my 4 year old son was born they pointed out a big 3/4 inch crevice at the top of his bottom crack and told us to watch it which we have. For a couple of weeks we've been finding a sort of discharge in his pants where the crevice would be, but thought nothing of it until I wiped it one day and saw a hole at the bottom of the crevice. It has a v thin layer of skin stopping it from being an actual hole. As a relative had had a similar problem and been operated on twice for it I sent a picture asking if it was the same thing and was told yes and to leave it. When I mentioned the discharge he panicked and told me to get my DS to a dr asap.

Can anyone tell me what they will do? I'm terrified in case they do what they did to my relative. Will they leave it alone?

Well they can't operate without your consent.

DH had two ops for this. It's a tricky op in terms of healing as skin is very thin and some degree of post op bed rest is usually required. I can't imagine they'd be particularly keen to rush him to surgery at 4.

You have to address it with GP though. If there is infection there he can at least be prescribed antibiotics.

FWIW my then 3 year old had an op under anaesthetic. My initial reaction when consultant recommended it was to say "No way". It was all I could do not to burst in to tears. It was the right thing to do though and now I'm glad we went through with it (after much agonising).

Yes my relative had 2 operations too and the last one they left an open cavity that had to be packed every day with gauze. Obviously they wouldn't do that to a 4 year old, but as it's gunking (my 4 yo's terminology) and the pit is getting further in would they be able to manage it with antibiotics? He had an op a year ago and I have to say nothing prepared me for the anaesthetic and how they suddenly drop.

I will get him seen by the dr tomorrow. Fingers crossed we can avoid an op. I think the reason it worries me is because of what happened to my relative. He didn't know what was going on so he packed it with toilet paper and wore sanitary towels to cover it up. One day he sat on the floor and got up and there was blood everywhere. Then the following ops. There's 14 years between My son and the time that the relative went through this though.

I wonder if there's a simpler solution when they're little or am I just giving in to wishful thinking?

I really don't know how they would treat a child with this. I hope the GP is able to reassure you. Would be interested to know what he thinks.

Good luck.

I'll let you know. Hopefully there's something that they can do. Polyfilla???

I have one but never needed an op. Never had any discharge though.

Have you made an appt with the GP yet? Maybe its some sort of infection and can be treated with antibiotics??????

they will probably pack it and give antibiotics ( after swabbing)and a if it is painful they somtimes give a codeine syrup ( pain killer not cough medicine) to take before packing it. Hope he heals up without too much problem.

I had this op fifteen years ago and I have to say, the pain post op was worse than childbirth, especially when they first removed the surgical dressing and started to pack it

I had the signs for five years previous, came about after a bad fall on ice, pushing some hair into the area I think. It was infected and my gp told me to have the hottest bath i could manage, with lots of salt in. This worked a treat, cleaned the infection.

It came back though, and the surgery was urgently required as the infection began to enter my system, was very ill. Really think there have been improvements recently though. They put a liquid into the wound to create a mould and use that to 'plug' the hole to allow it to heal from the inside out. A health visitor usually comes round each day to do this.

Hopefully you can avoid the op though. Bath with salt always worth a try. Poor wee soul.

I've made an appointment for next week for him to see the dr. He definitely needs seen as there's still some gunk coming out and the area looks quite pink. The actual hole looks red. I looked it up online and it's quite rare for such a young kid to get it like this as it's normally found around 14-30 year olds. My relative doesn't know why he got his but he had a 2 inch by 6 inch chunk cut out of his back the 2nd op round. It sounds absolutely awful and I really admire you having an op like that perfumedlife. It sounds agony.

Fingers crossed there's a way of avoiding it, but I get the feeling the poor little mans going to have to have it done at some point.

While you wait for the gp, please try the salt baths, they really can work wonders on the gunk. I know little one won't have it hot, but a cup of salt in warm water makes a good job of cleaning the area.

I wasn't brave op, was an emergency situation, blood poisoning by then. If your ds isn't complaining of severe pain on sitting, then it's probably not that infected yet, which is great.

Had this op 5 times in my life from 21 - 27yrs old. Wondered if it would ever get better. Met DH to be over these years and he nursed me through final op, even being my district nurse ( he nearly passed out when he first saw my wound in hospital when he was shown how to dress it and sort it out. Ended up being known as 'Operation Bottoms Up' every evening when he did my dressing---- can't believe I can sometimes be so mean to him after he put up with all that. Love him really!)
Even had to cancel our honeymoon abroad because of it, but thank goodness I did get better after this and have had no more problems (25 years married this year!)
I would say to you get this sorted out ASAP as maybe the op won't be so major on a little 4 year old.
It is a pain in the ass!

I have had an op for anal fistula. Its when it come from iternally to the skin. I have also had an abcess that was operated on. It sometimes opens so goes into sinus but other than that (and needing AB's occasionally) it is fine and I can can cope.

Only thing is its quite literally a PITA, I get quite a bad pain through my buttox at times and I know it will open a little. If you can get it sorted I would suggest you do if its bothering him.

Perfurmedlife- I definitely will. I'm a strong believer in salt baths for sore fingers etc so this is just up my alley. Thank you so much and I'll let you know how we get on

bearcat- was it the packing that you had to do? My relative had that and oh wow was it awful. I suppose a good thing came out of it with meeting your husband. It really is a novel way of telling people how you met ha ha. I suppose seeing the operation I'm loathe for my little boy to go through it so fingers crossed they've devised a miracle plaster or something?!

Heliumballoons- does yours never completely clear up? After so many antibiotics are you not immune to them now?

I just can't understand how a 4 year old can have such an aggravated version so young. He really does have the worst luck healthwise.

Nah I haven't had that many antibiotics i don't think . I ususally get flucloxicillen or co-amoxiclav. I have had abcesses behing my ear and also on mmy back as well.

It does close and ten opens again and GP says it going into sinus. It ten seems to eal and does it again. I'm talking every few months though not over a few days.

T.

sorry dodgy H button

Wow so it's kind of affecting everywhere on you isn't it? It must be so sore to sit on as well when it grumbles. What an absolute shame heliumbuloons :(

Polly
So long ago now, but yes had ridbbon gauze dressing and also some sort of sponge dressing that was chemically made to pour into and fit your wound as a 'made to measure' dressing in later operations.
It was awful at the time, but eventually we got there.
Sort your little boy out now while he's still young so it is not such a prolonged period when he is grown up.
Good luck. You'll get there.

I hate to say it but I've been abcess free for 8 months now touches all wood. But yes its can be a right PITA at times.

Hope all gets sorted for your DS, and I second the saltz bath but would consider surgery before it gets deeper.

Oh the gauze dressing It was so bad, the nurses took pity on me and told me to lie in a warm bath and remove it myself at my own pace. It took me two hours, taking a cm at a time out. This was the day after the op. To be fair, the days after were nothing like as sore, and the district nurse came and did it the first week, then my bf.

No wonder we split.

I agree with heliumballoons, it may well be best to get the op over and done with while ds is still young. They are such great healers at that age too.

My DH had this a few years ago and in the absence of decent info from the hospital, I contacted the bloke who wrote this useful review.

www.worldwidewounds.com/2003/december/Miller/Pilonidal-Sinus.html

His email is on the page. He was very helpful with info and recommendations.

I also remember him saying (IIRC) that the NHS doesn't have a specific pot of money for wound management, hence something like this, where the site often has to be cleaned and packed every day, can end up being badly managed. Leaving the wound "open", sounds awful, but allowing it to heal over without closing the skin together (kind of a DIY skin graft in essence) greatly reduces the recurrence of it. If you think of the PNS as a cavity which repeatedly gets infected, rather than repeatedly putting a lid on it, you just open the whole thing out and what was "the cavity" becomes new external skin (my DH's left a bit of a "hollow" on his buttock, but the infection never returned.)

here is a page on childhood PNS www.childrenshospital.org/az/Site923/mainpageS923P0.html

Sausagerolemodel- that is brilliant. Just what I was looking for. DS will be seen this week and hopefully we'll get it all sorted. That information is brilliant though. Thank you so much.

Perfumedlife and heliumballoons- my relative who had the op twice had a huge open wound the 2nd time that took a year to close. He used to sit in a salt bath for hours and let the packing float out so that the nurse could put more in. It was awful. When they did the op and let it close it was back within a couple months. It's a horrible horrible thing to have and if getting it fixed now means he won't have to have a bigger op later on I'm all for it. How brave are you having it done though. I'd have to be sedated the whole time ha ha.

Fingers crossed there's an easy fix for DS.

best of luck with your DS. I'm glad the info was useful. :-)