Umbilical Pilonidal Sinus: A Report of Two Cases and Recent Update of Literature
Susanta Meher1, Tushar Subhadarshan Mishra2, Prakash Kumar Sasmal3
1Senior Resident, Department of Surgery, AIIMS , Bhubaneswar, Odisha, India .
Insights
Umbilical Pilonidal Sinus (UPS) is a rare condition presenting with umbilical pain and discharge. Conservative management, including hair extraction, is effective for UPS, with no recurrence observed in a one-year follow-up.
Area of Science:
- General Surgery
- Dermatology
Background:
- Umbilical Pilonidal Sinus (UPS) is a rare differential diagnosis for umbilical diseases.
- It typically presents with umbilical pain and discharge, particularly in young, active males with dense abdominal hair and deep navels.
Observation:
- No consensus guidelines exist for UPS management due to its rarity.
- Treatment varies based on presentation, with conservative measures like hair extraction and hygiene being common.
Findings:
- Conservative management, specifically thorough hair extraction, is effective for UPS.
- Two cases of UPS managed conservatively showed no recurrence after one year.
Implications:
- Conservative management, emphasizing complete hair removal, can successfully treat UPS.
- Further research may help establish standardized management protocols for this uncommon condition.
Abstract:
Umbilical Pilonidal Sinus (UPS) is a rare differential diagnosis of umbilical disease as encountered by general surgeons. They usually present with history of pain and umbilical discharge. Young active adolescent males with dense hairy abdomen with a deep naval are at risk of developing this disease. There are no consensus guidelines for the management of this disease probably because of its rarity. Treatment depends on the type of presentation. Most of the cases are managed by conservative treatment with hair extraction and personal hygiene. Surgery is indicated in case of failure of conservative management. Although umbilectomy is a commonly done procedure, complete sinus excision with reconstruction which can be done to have better cosmesis. Incomplete hair extraction from the sinus tract has been found to be the commonest cause of failure of conservative management. In this paper we have presented two cases of UPS, managed conservatively, with no recurrence after one year of follow-up. We have also presented a recent update on current literature about this uncommon disease.
