Pilonidal sinus

Question 1

Define pilonidal sinus

Answer 1

Abnormal epithelium-lined tract filled w/ hair that opens onto the skin surface, most commonly in the natal cleft

Question 2

Aetiology of pilonidal sinus

Answer 2

Caused by shed or sheared hairs penetrating the skin & inciting inflammatory reaction & sinus development
Intermittent negative pressure will draw in more hair & perpetuate cycle

Question 3

Risk factors for pilonidal sinus

3

Answer 3

Hirsutism
Spending a long time sitting
Occupation

Question 4

Epidemiology of pilonidal sinus

prevalence

Answer 4

COMMON

Affects 0.7% young adults

Question 5

Presenting symptoms of pilonidal sinus

3

Answer 5

Painful natal cleft
Discharging swelling
Often recurrent

Question 6

Signs of pilonidal sinus on physical examination

4

Answer 6

Midline openings or pits between buttocks
Hairs may protrude from swelling
If infected or abscess, swelling will become tender
May be fluctuant & discharge pus or blood-stained fluid on compression

Question 7

Investigations for pilonidal sinus

general + 1-2

Answer 7

NONE needed

Bloods - to check for signs of infection
Raised WCC
Fasting glucose

Question 8

Management of pilonidal sinus

acute, chronic, 2 prevention

Answer 8

Acute pilonidal abscess
Incision & drainage

Chronic pilonidal sinus
Excision under GA w/ exploration

Prevention
Good hygiene
Shaving

Question 9

Complications of pilonidal sinus

4

Answer 9

Pain
Infection
Abscess
Recurrence

Question 10

Prognosis of pilonidal sinus

3

Answer 10

Good w/ drainage
Shaving cures in most cases
Usually resolves by age 40