The Value of Superficial Parts and Endoanal Ultrasonography in Evaluating Pilonidal Disease and Exclusion of Perianal Sepsis

Overview

Journal J Ultrasound

Publisher Springer

Specialty Radiology

Date 2015 Aug 12

PMID 26261474

Citations 5

Authors

Ashraf Talaat Youssef

Affiliations

Soon will be listed here.

Abstract

Introduction: Pilonidal disease is a benign anorectal inflammatory disease that involves the subcutaneous adipose tissue overlying the sacrococcygeal region.

The Aim Of The Work: The current study aimed to assess the value of preoperative evaluation of pilonidal disease and the exclusion of perianal sepsis using superficial parts ultrasonography and endoanal ultrasound.

Methodology: Referred 30 patients were clinically diagnosed as pilonidal disease, all were examined with superficial parts ultrasonography and if the disease was extending to the perianal region further endoanal US was performed to exclude perianal sepsis.

Results: 7 patients showed subcutaneous abscesses and 23 patients showed pilonidal sinus tracts. Among patients with pilonidal sinus tracts, six tracts (26 %) seen as superficially situated, short narrow tracts with straight course, no side branches and with a blind end situated away from the anal canal wall. 2 (9 %) tracts showed vertical orientation and three tracts (13 %) were wide and deeply situated reaching the presacral fascia. 7 cases (30 %) showed branching pilonidal sinus tracts, two cases of them showed more than one external opening. 5 patients (22 %) showed abnormally long tracts seen reaching the perianal region.

Conclusion: Ultrasonography is an available, inexpensive, safe imaging modality that yields a high degree of accuracy in evaluating pilonidal disease and in exclusion of perianal sepsis.

Citing Articles

Subarachnoid anesthesia for sacrococcygeal pilonidal disease treatment: A case report.

Qin Z, Zhao X, Feng J, Li J Medicine (Baltimore). 2024; 103(51):e40998.

PMID: 39705452 PMC: 11666127. DOI: 10.1097/MD.0000000000040998.

Magnetic resonance imaging of pilonidal sinus disease: interobserver agreement and practical MRI reporting tips.

Abdelatty M, Elmansy N, Saleh M, Salem A, Ahmed S, Gadalla A Eur Radiol. 2023; 34(1):115-125.

PMID: 37566273 PMC: 10791724. DOI: 10.1007/s00330-023-10018-2.

Consensus statement of the Italian society of colorectal surgery (SICCR): management and treatment of pilonidal disease.

Milone M, Basso L, Manigrasso M, Pietroletti R, Bondurri A, La Torre M Tech Coloproctol. 2021; 25(12):1269-1280.

PMID: 34176001 PMC: 8580911. DOI: 10.1007/s10151-021-02487-8.

Coexistance of Gynecomastia and Poland Syndrome: Case Report.

Yuce E, Sirvan S, Akgun Demir I, Eren H, Karsidag S Sisli Etfal Hastan Tıp Bul. 2020; 53(3):314-317.

PMID: 32377103 PMC: 7192283. DOI: 10.14744/SEMB.2017.29494.

Obesity, Hypertrichosis and Sex Steroids: Are these Factors Related to the Pilonidal Sinus Disease?.

Ekici U, Ferhatoglu M Sisli Etfal Hastan Tıp Bul. 2020; 53(3):263-266.

PMID: 32377093 PMC: 7192277. DOI: 10.14744/SEMB.2019.78800.

References

Mahdy T . Surgical treatment of the pilonidal disease: primary closure or flap reconstruction after excision. Dis Colon Rectum. 2008; 51(12):1816-22. DOI: 10.1007/s10350-008-9436-8. View

Mentes O, Oysul A, Harlak A, Zeybek N, Kozak O, Tufan T . Ultrasonography accurately evaluates the dimension and shape of the pilonidal sinus. Clinics (Sao Paulo). 2009; 64(3):189-92. PMC: 2666454. DOI: 10.1590/s1807-59322009000300007. View

Cihan A, Mentes B, Tatlicioglu E, Ozmen S, Leventoglu S, Ucan B . Modified Limberg flap reconstruction compares favourably with primary repair for pilonidal sinus surgery. ANZ J Surg. 2004; 74(4):238-42. DOI: 10.1111/j.1445-2197.2004.02951.x. View

Kulacoglu H, Dener C, Tumer H, Aktimur R . Total subcutaneous fistulectomy combined with Karydakis flap for sacrococcygeal pilonidal disease with secondary perianal opening. Colorectal Dis. 2006; 8(2):120-3. DOI: 10.1111/j.1463-1318.2005.00872.x. View

RAFFMAN R . A re-evaluation of the pathogenesis of pilonidal sinus. Ann Surg. 1959; 150:895-903. PMC: 1613439. DOI: 10.1097/00000658-195911000-00014. View

Can M, Sevinc M, Yilmaz M . Comparison of Karydakis flap reconstruction versus primary midline closure in sacrococcygeal pilonidal disease: results of 200 military service members. Surg Today. 2009; 39(7):580-6. DOI: 10.1007/s00595-008-3926-0. View

Ziech M, Felt-Bersma R, Stoker J . Imaging of perianal fistulas. Clin Gastroenterol Hepatol. 2009; 7(10):1037-45. DOI: 10.1016/j.cgh.2009.06.030. View

Kronborg O, Christensen K, ZIMMERMANN-NIELSEN C . Chronic pilonidal disease: a randomized trial with a complete 3-year follow-up. Br J Surg. 1985; 72(4):303-4. DOI: 10.1002/bjs.1800720418. View

McCallum I, King P, Bruce J . Healing by primary closure versus open healing after surgery for pilonidal sinus: systematic review and meta-analysis. BMJ. 2008; 336(7649):868-71. PMC: 2323096. DOI: 10.1136/bmj.39517.808160.BE. View

10.

Lee H, Ho Y, Seow C, Eu K, Nyam D . Pilonidal disease in Singapore: clinical features and management. Aust N Z J Surg. 2000; 70(3):196-8. DOI: 10.1046/j.1440-1622.2000.01785.x. View

11.

Karydakis G . Easy and successful treatment of pilonidal sinus after explanation of its causative process. Aust N Z J Surg. 1992; 62(5):385-9. DOI: 10.1111/j.1445-2197.1992.tb07208.x. View

12.

Taylor S, Halligan S, Bartram C . Pilonidal sinus disease: MR imaging distinction from fistula in ano. Radiology. 2003; 226(3):662-7. DOI: 10.1148/radiol.2263011758. View

13.

Bulent Mentes B, Leventoglu S, Cihan A, Tatlicioglu E, Akin M, Oguz M . Modified Limberg transposition flap for sacrococcygeal pilonidal sinus. Surg Today. 2004; 34(5):419-23. DOI: 10.1007/s00595-003-2725-x. View

14.

Onder A, Girgin S, Kapan M, Toker M, Arikanoglu Z, Palanci Y . Pilonidal sinus disease: risk factors for postoperative complications and recurrence. Int Surg. 2012; 97(3):224-9. PMC: 3723218. DOI: 10.9738/CC86.1. View

15.

da Silva J . Pilonidal cyst: cause and treatment. Dis Colon Rectum. 2000; 43(8):1146-56. DOI: 10.1007/BF02236564. View

16.

Sondenaa K, Diab R, Nesvik I, Gullaksen F, Kristiansen R, Saebo A . Influence of failure of primary wound healing on subsequent recurrence of pilonidal sinus. combined prospective study and randomised controlled trial. Eur J Surg. 2003; 168(11):614-8. DOI: 10.1080/11024150201680007. View

17.

Bendewald F, Cima R . Pilonidal disease. Clin Colon Rectal Surg. 2009; 20(2):86-95. PMC: 2780177. DOI: 10.1055/s-2007-977486. View

18.

Akinci O, Coskun A, Ozgonul A, Terzi A . Surgical treatment of complicated pilonidal disease: limited separate elliptical excision with primary closure. Colorectal Dis. 2006; 8(8):704-9. DOI: 10.1111/j.1463-1318.2006.01022.x. View