Acta Scientific Gastrointestinal Disorders (ASGIS)(ISSN: 2582-1091)

Research Article Volume 4 Issue 11

Pilonidal Sinus Mimicking Fistula in Ano in a Male Patient. A Case Report and Review of Literature

Nicos Kritharides*, Georgios Rallis and Aikaterini Leventi

Surgical Department, “ELPIS” General Hospital, Athens, Greece

*Corresponding Author: Nicos Kritharides, Surgical Department, “ELPIS” General Hospital, Athens, Greece.

Received: August 31, 2021; Published: October 20, 2021

×

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

×

References

  1. Lim J and Shabbir J. “Pilonidal Sinus Disease - A Literature Review”. World Journal of Surgery and Surgical Research 2 (2019): 1117.
  2. Jeremy Sugrue., et al. “Pathogenesis and persistence of cryptoglandular anal fistula: a systematic review”. Techniques in Coloproctology 21 (2017): 425-432.
  3. Chiara Eberspacher., et al. “Pilonidal disease mimicking anterior anal fistula and associated with posterior anal fistula: a two-step surgery”. Case Report. G Chir6 (2017): 313-317.
  4. Corey W Iqbal., et al. “Pilonidal Disease Mimicking Fistula-in-Ano in a 15-Year-Old Female”. Hindawi Publishing Corporation, Case Reports in Surgery (2012).
  5. S Vallance. “Pilonidal fistulas mimicking fistulas-in-ano”. British Journal of Surgery 3 (1982): 161-162.
  6. V De Parades., et al. “Pilonidal sinus disease”. Journal of Visceral Surgery4 (2013): 237-247.
  7. Stuart A Taylor., et al. “Pilonidal Sinus Disease: MR Imaging Distinction from Fistula in Ano”. Radiology 226 (2003): 662-667.
  8. Pankaj Garg. “Anal fistula and pilonidal sinus disease coexisting simultaneously: An audit in a cohort of 1284 patients”. International Wound Journal 5 (2019): 1199-1205.
  9. Giuseppe Accarpio MD., et al. “Pilonidal Sinus with an Anal Canal Fistula-Report of a Case”. Diseases of the Colon and Rectum12 (1988): 965-967.
  10. Gerald Mason Feigen MD., et al. “Pilonidal Disease Simulating Rectal Abscess and Fistula”. The Art and Science of Surgery 2 (1956): 258-260.
  11. A Amato., et al. “Evaluation and management of perianal abscess and anal fistula:a consensus statement developed by the Italian Society of Colorectal Surgery (SICCR)”. Techniques in Coloproctology 19 (2015): 595-606.
  12. Matthew Sammu Paul Skaife. “The management of cryptoglandular fistula-in-ano”. British Journal of Hospital Medicine1 (2020).
  13. Iesalnieks I and Ommer A. “The management of pilonidal sinus”. Deutsches Ärzteblatt International 116 (2019): 12-21.
  14. J Harju., et al. “Pilonidal Disease Treatment By Radial Laser Surgery (FilaC™): The First Finnish Experience”. Scandinavian Journal of Surgery (2020): 1457496920975610.
  15. H Elfeki., et al. “A systematic review and meta‑analysis of the safety and efficacy of fistula laser closure”. Techniques in Coloproctology (2020).
×

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..




Metrics

Acceptance rate35%
Acceptance to publication20-30 days
Impact Factor0.835

Indexed In




News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is December 05, 2021.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of “Best Article of the Issue”.
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.
  • Contact US