Umbilical Pilonidal Sinus: a Case Report and Systematic Review

Area of Science:

• Medical Case Reports
• Surgical Techniques
• Pilonidal Sinus Disease

Background:

• Umbilical pilonidal sinus (UPS) is a rare congenital condition characterized by sinus tract formation in the umbilical region.
• It is often associated with chronic inflammation and hair accumulation, leading to frequent underdiagnosis due to nonspecific presentation.
• Delayed diagnosis of UPS can impede appropriate and timely management.

Purpose of the Study:

• To systematically review existing literature on UPS globally and in Saudi Arabia.
• To delineate the clinical presentation and identify risk factors associated with UPS.
• To propose a management algorithm and report outcomes for UPS.

Main Methods:

• A systematic literature review was conducted on Umbilical Pilonidal Sinus (UPS).
• A case report of a 19-year-old male with UPS is presented, detailing his presentation, diagnosis, and surgical management.
• Analysis of correlated risk factors such as hirsutism, deep navels, BMI, and family history was performed.

Main Results:

• UPS is more prevalent in males, with identified risk factors including hirsutism, deep umbilicus, elevated BMI, and a family history of pilonidal sinuses.
• A diagnostic criterion and a 'Step-up' management approach are proposed based on the findings.
• The case report details successful surgical excision and post-operative recovery with minor complications.

Conclusions:

• This study highlights the diagnostic challenges associated with UPS.
• It reviews conservative and surgical management options for UPS.
• Addressing the scarcity of UPS data is crucial for evidence-based, patient-centered care.