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previously visited 070206 ABDOMINAL WALL ABSCESS POSSIBLY SECONDARY FROM DERMAL SINUS TRACT INFECTION Random Case
Authored By: pedrad CSH, Radiologist, Chung Shan Medical University Hospital, Taiwan.
Patient: 3 month old male
History: Fever and poor intake for 2 days.
Images:small[medium]largeas-submittedimages only

Fig. 1: Photo_1

Fig. 2: Photo_2

Fig. 3: MRI_sagittal_1

Fig. 4: MRI_sagittal_2

Fig. 5: MRI_axial

Fig. 6: MR_T2_sagittal_1

Fig. 7: MR_T2_sagittal_2

Fig. 8: MR_T2_sagittal_3

Fig. 9: MR_Myelography_sagittal
Images:small[medium]largeas-submittedimages only
Findings: Figure 1-2:
1. A small round wound in midline of buttock, above to anus.
2. Relative increased hairs near wound.
3. Reddish skin of lower back.

Figure 3-9:
1. Eextensive fluid accumulation with internal heterogeneous
   signal intensity and peripheral contrast enhancement in
   subcutaneous tissue of abdominal wall, chiefly in lower back,
   between superficial fatty layer (Camper fascia) and
   deep membranous layer (Scarpa fascia), with T5 cranial
   dissection and coccyx caudal extension, in favor of abscess
   with small hemorrhage or gas formation.
2. Small long T1 and T2 signals with contrast enhancement in
   subcutaneous tissue of coccygeal region, compatible with
   infectious fistula track.
3. Although there is no direct MR evidence, the subcutaneous abscess
   may secondarily come from a coccygeal dermal sinus tract
   (a potential repeated infectious source).
Diagnosis: Abdominal wall abscess possibly secondary from dermal sinus tract infection
Comments: post a comment

Q: What is the hallmark of dermal sinus?

A: Midline cutaneous dimple overlying the spine.

1. They are epithelium-lined tubes extending from the skin

   inward to varying depths.

2. They may terminate in the subcutaneous tissue, paraspinal

   muscle, vertebrae, dura, or spinal cord.

3. They can occur at any level along the spinal axis but are

    most commonly seen in the lower lumbosacral segment.

4. Coccygeal dermal sinus is not common.

By Dr. Tsao

--pedrad CSH, 2007-02-15 06:46:30
Additional Details:

Case Number: 8114982Last Updated: 02-19-2007
Rating:

1 rating
Anatomy: Spine and Peripheral Nervous System   Pathology: Infection
Modality: Photograph, MRAccess Level: Readable by all users
Keywords: abscess, dermal sinusACR: 339.244
Case has been viewed 1346 times.

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