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This is highly likely to be a pilonidal sinus because of the hair coming out of the midline pit (Fig. 29.1). The presence of the lateral opening really makes it a fistula (not an anal fistula … it’s not coming from the anus). If the hair wasn’t visible, one of the differential diagnoses would be an anal fistula presenting with posterior openings in the natal cleft. One of the reasons for the failure of surgery for a “pilonidal” sinus is that the “sinus” was actually an anal fistula all along. It is certainly worth careful probing to make sure there is no track that heads south to the anus.

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How Would You Treat This Example of Relatively Mild but Still Symptomatic Pilonidal Disease?

  • 章节

  • 发表日期：

    2025年

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  • James M. Church

摘要

This is highly likely to be a pilonidal sinus because of the hair coming out of the midline pit (Fig. 29.1). The presence of the lateral opening really makes it a fistula (not an anal fistula … it’s not coming from the anus). If the hair wasn’t visible, one of the differential diagnoses would be an anal fistula presenting with posterior openings in the natal cleft. One of the reasons for the failure of surgery for a “pilonidal” sinus is that the “sinus” was actually an anal fistula all along. It is certainly worth careful probing to make sure there is no track that heads south to the anus.