Understanding Cyst, Ulcer, Fistula & Sinus

• b-Tubuloembryonic cysts: collection of embryonic remnants, includes ependymal cyst (thryoglossal cyst, Ependymal cyst), acquired, and parasitic cysts.
• Cysts can be classified based on their origin:
  • Retention cysts: result from the accumulation of secretion in glands due to obstruction of ducts (sebaceous cyst, parotid gland cyst).
  • Traumatic cysts: caused by injury, such as a cystic tumor (cystic teratoma, cystadenoma).
  • Degeneration cyst: degenerative changes within a cyst.
  • Distension cyst: distension from the accumulation of fluid within a cyst (thyroid cyst, lymphatic cyst, hydrocele).
  • Parasitic cyst: caused by parasitic infestation, such as a hydatid cyst.
• Clinical features vary according to site and size of the cyst:
  • Pain: enlarging cysts, secondary to haemorrhage, infection, rupture, or torsion.
  • Compression symptoms: haemorrhage in thyroglossal cyst, large ovarian cyst, obstruction to pelvic veins, causing varicose veins of the lower limbs.
• Diagnosis can be obvious in superficial cysts but may require ultrasound, CT scan, or MRI for deep-seated intra-abdominal or thoracic cysts.
• Complications include infection, haemorrhage, torsion, obstruction, calcification, and malignancy (rare).
• An ulcer is a break in the continuity of an epithelial surface, characterized by progressive destruction of the epithelium and a granulating base.
• Clinical examination includes assessment of size, shape, edge, floor, base, discharge, surrounding area, and lymph nodes.
• Management involves treating the cause of the ulcer, identifying and correcting comorbid factors, adequate drainage and debridement, antiseptics and topical antibiotics, and wound dressings (hydrogel, alginate, lyofoam, tegaderm, alleyn).
• A fistula is a communicating track between two epithelial surfaces, commonly between a hollow viscus and the skin (external fistula) or between two hollow viscera (internal fistula). The track is lined with granulation tissue and subsequently epithelialized.
• Fistulas require accurate assessment, as well as treatment of the underlying cause, drainage, and wound care with hydrogel, alginate, lyofoam, tegaderm, and alleyn.

This quiz covers the characteristics and classifications of cysts, including true and false cysts, as well as information about ulcers, fistulas, and sinuses. The content is provided in both English and Arabic.