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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
PubMed
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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.

Related Experiment Videos

  • 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.