Summary
Definition
History and exam
Key diagnostic factors
- sacrococcygeal discharge
- sacrococcygeal pain and swelling
- sacrococcygeal sinus tracts
Other diagnostic factors
- at risk demographic (male, age 16 to 40 years)
- history of prior rupture of fluid into natal cleft
- skin maceration
- acutely increased natal cleft pain and swelling
- fever or toxemia
Risk factors
- male gender
- age 16 to 40 years
- family history of pilonidal disease
- stiff hair and hirsutism
Diagnostic investigations
1st investigations to order
- clinical diagnosis
Treatment algorithm
asymptomatic
symptomatic: primary disease
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 DifferentialsGuidelines
- Practice parameters for the management of pilonidal disease
- SSAT patient care guidelines: treatment of perineal suppurative processes
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