Overview:
- A pilonidal sinus or hair sac is a small opening above the coccyx (at middle of upper buttock area) that leads to a collection under the skin that may contain hair.
- pilonidal sinus is a common disease that gives no symptoms unless inflamed
Etiology:
There are two theories:
- first one assumes presence of a birth defect in the fetal life led to the survival of some cells belonging to the skin near the coccyx bone, and over time these cells begin to produce hair, which leads to the formation of an inflamed sac containing hairs that open on the skin to form a fistula
- second one assumes that the friction and long sitting on the coccygeal area pushes the hair to grow inside the skin, which leads to formation of a hair sac that becomes inflamed and opens on the skin
Symptoms:
- Severe pain in the coccyx
- Redness
- Swelling
- Bloody or purulent discharge
- An abscess may form
Causes:
- Genetic predispositions
- Long sitting as driving
- Pressure and friction in the coccyx area causes hair to be pushed into the skin
- Hairy people: so it is more common in men especially with young age
- Obesity
Diagnosis:
- clinical examination
- We may need MRI in complex cases
Treatment:
Treatment of coccygeal fistula surgically
Drainage of abscess
Pilonidal Sinus excision
Excision of the pilonidal sinus with a skin flap: in large and recurrent cases
Closure of sinus with the assistance of video VAAFT:
Sinus tract is probed with a rigid scope,
all unhealthy tissues are removed with tiny grasper
sinus is closed by the application of LASER ablation with complete detection with scope
