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The value of superficial parts and endoanal ultrasonography in evaluating pilonidal disease and exclusion of perianal sepsis

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Abstract

Introduction

Pilonidal disease is a benign anorectal inflammatory disease that involves the subcutaneous adipose tissue overlying the sacrococcygeal region.

The aim of the work

The current study aimed to assess the value of preoperative evaluation of pilonidal disease and the exclusion of perianal sepsis using superficial parts ultrasonography and endoanal ultrasound.

Methodology

Referred 30 patients were clinically diagnosed as pilonidal disease, all were examined with superficial parts ultrasonography and if the disease was extending to the perianal region further endoanal US was performed to exclude perianal sepsis.

Results

7 patients showed subcutaneous abscesses and 23 patients showed pilonidal sinus tracts. Among patients with pilonidal sinus tracts, six tracts (26 %) seen as superficially situated, short narrow tracts with straight course, no side branches and with a blind end situated away from the anal canal wall. 2 (9 %) tracts showed vertical orientation and three tracts (13 %) were wide and deeply situated reaching the presacral fascia. 7 cases (30 %) showed branching pilonidal sinus tracts, two cases of them showed more than one external opening. 5 patients (22 %) showed abnormally long tracts seen reaching the perianal region.

Conclusion

Ultrasonography is an available, inexpensive, safe imaging modality that yields a high degree of accuracy in evaluating pilonidal disease and in exclusion of perianal sepsis.

Riassunto

Introduzione

La malattia pilonidale (PND) è una patologia infiammatoria ano-rettale benigna che coinvolge il tessuto adiposo sottocutaneo sovrastante la regione sacro-coccigea.

Scopo

scopo dello studio è stato evidenziare il ruolo dell’ecografia delle parti molli ed endorettale nella valutazione preoperatoria della malattia pilonidale e nell’escludere la sepsi perianale.

Materiali e Metodi

sono stati presi in esame 30 pazienti ai quali era stata diagnosticata clinicamente la malattia pilonidale, tutti sono stati sottoposti ad esame ecografico delle parti molli, se la malattia si era diffusa anche alla regione perianale, sono stati ulteriormente sottoposti ad esame ecografico endorettale per escludere sepsi perianale.

Risultati

7 pazienti mostravano ascessi sottocutanei e 23 cisti pilonidali. Tra questi ultimi, 6 (26 %) presentavano cisti con localizzazione superficiale, a decorso stretto e lineare, senza ramificazioni laterali e con un fondo cieco situato lontano dalla parete del canale anale. 2 pazienti (9 %) mostravano cisti ad orientamento verticale e 3 (13 %) sito ampio e profondo fino a raggiungere la fascia presacrale. 7 casi (30 %) mostravano ramificazione delle fistole pilonidali, di cui 2 con più di un’apertura esterna. 5 casi (22 %) cisti estremamente lunghe fino a raggiungere la regione perianale.

Conclusione

L’ecografia è una modalità d’indagine economica e sicura con un alto grado di precisione nella valutazione della malattia pilonidale e nell’esclusione la sepsi perianale.

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Conflict of interest

The author declares that he has no conflict of interest.

Informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). All patients provided written informed consent to enrolment in the study and to the inclusion in this article of information that could potentially lead to their identification.

Human and animal studies

The study was conducted in accordance with all institutional and national guidelines for the care and use of laboratory animals.

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Authors and Affiliations

  1. Department of Radiology, Faculty of Medicine, Fayoum University, El Fayoum, Egypt

    Ashraf Talaat Youssef

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  1. Ashraf Talaat Youssef
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Correspondence to Ashraf Talaat Youssef.

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Youssef, A.T. The value of superficial parts and endoanal ultrasonography in evaluating pilonidal disease and exclusion of perianal sepsis. J Ultrasound 18, 237–243 (2015). https://doi.org/10.1007/s40477-015-0156-3

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  • DOI: https://doi.org/10.1007/s40477-015-0156-3

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