ZocdocAnswersIs this a Pilonidal recurrence/ fistula in ano?

Question

Is this a Pilonidal recurrence/ fistula in ano?

Hello Did pilonidal surgery 2 yrs ago. Surgeon cut along side of cleft and closed wound but left a drain opening just at the end of the scar approximately 2cm above anus. Scar has healed but is constantly pink in colour and sometimes itchy. I spread infront of the fan to dry after every shower and then use a bit of petroleum jelly. Approx one week now, i assumed after "forcing", the scar became inflamed and hard over a couple days. I began feeling bit of an internal fever and the area was obviously sore and at times painful. On the fourth day i noticed a bit of blood/pus after wiping. Since then it drains a little now and then. Just under the skin on the right side of the stitch there is a yellow worm like swelling which i assume to be pus. Does the mean a recurrence of the cyst, a new one, fistula en ano??? Please advise. Options/ Surgery again/ Homoeotherapy etc

Answer

Based on your description of blood/pus, swelling, fever, and drainage, I am most concerned about an infection. This could be an infection of the skin in the area, or could be a collection of pus that's formed at the site, which would be called an abscess. If you are having fevers, increasing pain and swelling, and increased drainage, you should go see a doctor as soon as possible to have this evaluated. These kinds of infections can sometimes spread and become serious and would need to be treated as soon as possible, most likely with drainage and antibiotics. It is also possible that the area is irritated and inflamed, and it is certainly possible that the cyst has re-accumulated. A fistula is less likely unless you have had chronic, low-level inflammation that has created a passage between your skin and another site. You would likely have drainage from that and possible notice a tract. At this time I would avoid manipulating the site too much; you can put a hot compress over the area to help it drain, and I would go as soon as possible to the doctor; if you have continued to have fevers, shaking chills, or otherwise feel unwell, I would go to the emergency room for sooner evaluation.

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