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Perineal pilonidal sinus. Case report
M Testini1, S Miniello, B Di Venere
1Vascolare ed Oncologia Clinica Dipartimento per le Applicazioni in Chirurgia delle Tecnologie Innovative Facoltà di Medicina e Chirurgia Università degli Studi di Bari, Policlinico P.za Giulio Cesare 70124 Bari, Italy. mario.testini@tin.it
Annali Italiani Di Chirurgia
|November 5, 2002
Summary
This case report details a rare instance of a perianal pilonidal sinus, a condition typically found in the sacral region. The patient, a baker, presented with symptoms mimicking other anal conditions, highlighting the importance of considering unusual presentations of pilonidal disease.
Area of Science:
- Colorectal Surgery
- Dermatology
- Surgical Pathology
Background:
- Pilonidal sinus commonly affects the sacral area.
- Perianal presentation of pilonidal sinus is exceptionally rare.
- Distinguishing perianal pilonidal sinus from other anal pathologies is clinically significant.
Observation:
- A 28-year-old male baker presented with a 7-month history of perianal swelling, pain, itching, and seropurulent discharge.
- Physical examination revealed multiple cutaneous fistulas around the anus.
- Imaging studies, including fistulography, endoscopy, and MRI, ruled out communication with the anal canal, suggesting a perianal origin.
Findings:
- Surgical exploration confirmed a perianal mass containing hair.
- Excision of the mass and fistulas resulted in rapid and uncomplicated healing.
- Histological examination confirmed a perineal pilonidal sinus with a foreign body inflammatory reaction.
Implications:
- This case underscores the importance of considering rare presentations of pilonidal sinus in the differential diagnosis of perianal conditions.
- Accurate diagnosis through imaging and surgical exploration is crucial for effective treatment.
- Understanding the foreign body reaction is key to managing these unusual cases.