Pilonidal D.

Question 1

Incidence of pilonidal D.

Answer 1

Age: in 2nd & 3rd
Sex: male: > female 2:1

Question 2

Risk factors of pilonidal D.

Answer 2

1. Family HX
2. Obesity
3. Poor hygiene
4. Hirsutism
   S. Deep natal cleft
5. Job → prolonged sitting
   7 sweating

Question 3

Sites of PD

Answer 3

Most common → sacrococcygeal region
Rare → interdigital - breast - umbilicus

Question 4

Pathogenesis of PD

Answer 4

• The local anatomy creates an unfavorable environment where friction, warmth, moisture,
and perhaps local hypoxia.

• Trapping of hairs.

• A granulomatous foreign body-type reaction.

• Disease typically begins as a small sinus that may drain fluid then progress to numerous
sinuses with associated cystic dilation and potential abscess formation.

Question 5

Symptoms of PD

Answer 5

A . may be asymptomatic
B. Pain over sacrococcageal area
Discharge
C. Acute abscess
D. Open wounds

Question 6

Acute pilonidal abscess associated with

Answer 6

overlying erythema,
fluctuance, and severe local tenderness, furthermore, fever may also occur.

Question 7

Investigation of PD

Answer 7

Does not require

Question 8

Non-operative TTT in PD ! indication

Answer 8

• Asymptomatic patients with no concerning findings, they require no operative management.
• Also appropriate for improvement in symptoms or quiescence in mild cases.

Question 9

Non-operative TTT in PD

Answer 9

Risk factor modification such as
weight loss,
avoidance of prolonged sitting at work,
improved hygiene,
and weekly clipping of hair in and adjacent to the natal cleft.

Question 10

Management of recurrent pd

Answer 10

Flap

Question 11

Management of chronic pilonidal

Answer 11

① endoscopic
② lay-open
③ wound closure