Pilonidal disease

Last reviewed: 26 Apr 2022
Last updated: 22 Sep 2020

Summary

Definition

History and exam

Key diagnostic factors

  • sacrococcygeal discharge
  • sacrococcygeal pain and swelling
  • sacrococcygeal sinus tracts
More key diagnostic factors

Other diagnostic factors

  • presence of risk factors
  • history of prior rupture of fluid into natal cleft
  • skin maceration
  • acutely increased natal cleft pain and swelling
  • fever or toxaemia
Other diagnostic factors

Risk factors

  • male sex
  • age 16 to 40 years
  • family history of pilonidal disease
  • stiff hair and hirsutism
More risk factors

Diagnostic investigations

1st investigations to order

  • clinical diagnosis
More 1st investigations to order

Treatment algorithm

ACUTE

asymptomatic

symptomatic: primary disease

ONGOING

symptomatic: recurrent disease

Contributors

Authors

Iain J.D. McCallum, PhD, FRCS

Consultant Surgeon

Department of General Surgery

Northumbria Healthcare NHS Foundation Trust

UK

Disclosures

IJDM is an author of a reference cited in this topic.

Acknowledgements

Mr Iain J.D. McCallum would like to gratefully acknowledge Dr Seamus Kelly, a previous contributor to this topic. SK declares that he has no competing interests.

Peer reviewers

Maher A. Abbas, MD, FACS, FASCRS

Assistant Clinical Professor of Surgery

UCLA

Chief of Colon and Rectal Surgery Chair

Center for Minimally Invasive Surgery Kaiser Permanente

Los Angeles

CA

Disclosures

MAA declares that he has no competing interests.

Angus J.M. Watson, FRCS (Ed)

Consultant Colorectal Surgeon

Clinical Manager of General Surgery and ETC

Department of Surgery

Manchester Royal Infirmary

Manchester

UK

Disclosures

AJMW is an author of a reference cited in this monograph.

  • Differentials

    • Perianal fistula
    • Perianal abscess
    • Hidradenitis suppurativa
    More Differentials
  • Guidelines

    • Practice parameters for the management of pilonidal disease
    • German national guideline on the management of pilonidal disease
    More Guidelines
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