Abstract

Introduction: Pilonidal Sinus typically presents as an abscess, purulent discharge, or pits around midgluteal cleft. In rare cases sinuses progress anteriorly mimicking Fistulas in Ano. Clinicians and especially surgeons should be aware of this situation, in order to avoid reoperations and patient’s discomfort and frustration.

Materials and Methods: A 41 years old male, presented at the outpatient Surgical Clinic of our hospital on Oct 2018, due to perianal pus irritation persistent for a decade. On clinical examination, we observed an external perianal opening draining pus, without other findings. A pelvis MRI followed for further investigation. A perianal fistula was demonstrated, and the patient was submitted to fistulectomy and Seton positioning. Two months later a fistula recurrence was observed and a second MRI was followed. The anal fistula was related with a misdiagnosed pilonidal sinus. Our patient undergone a second procedure for fistulectomy and a pilonidal sinus removal. Seven months later the third operation was accomplished and both the sinus and the fistula were treated successfully with FiLaC™ technique (Fistula - Tract Laser Closure). Patient had a follow up of a period of one year and he was in an excellent condition without symptoms of recurrence.

Results and Discussion: In rare situations Pilonidal Sinuses appear as Fistulas in Ano. Few cases are described in the literature but it seems to be a more common situation than we believe. There are three main theories explaining this incident.

Conclusion: Surgeons should be aware for this entity in order to avoid unnecessary reoperations and patient’s dissatisfaction. Appropriate preoperative imaging (MRI-Magnetic Resonance Imaging or EUS- Endorectal Ultrasound) and a two step surgery are the main keys for a successful management

Keywords: Anal Fistula; Pilonidal Sinus; Recurrence; Anal Fistula Treatment

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Citation

Citation: Nicos Kritharides., et al. “Pilonidal Sinus Mimicking Fistula in Ano in a Male Patient. A Case Report and Review of Literature”. Acta Scientific Gastrointestinal Disorders 4.11 (2021): 06-11..

Copyright

Copyright: © 2021 Nicos Kritharides., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.