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Conservative vs. Surgical Interventions for Umbilical Pilonidal Sinus

  • Mehmet Kaplan
  • Huseyin Cahit Yalcin
  • Onder Ozcan
  • Fatma Cigdem Kaplan
Part of the Recent Clinical Techniques, Results, and Research in Wounds book series


Umbilical pilonidal sinus (UPS) is a rare condition mostly seen in hairy young males and characterized by pain, swelling, bleeding, and seropurulant discharge from the umbilicus. Although it has long been recognized, it is yet little known clinical entity. Furthermore, there are some doubts regarding its best treatment options. Umbilicus is one of the ideal sites for pilonidal sinus formation. It occurs penetration of vulnerable skin of the umbilicus by hair which causing a foreign-body reaction and development of the sinus. Treatment depends on the severity of the disease, ranging from good personal hygiene to surgical excision of umbilical complex. However, most of the cases are administered with chronic intermittent form of the disease; for those patients the best permanent solution is umbilicus-preserving surgery.



The authors wish to thank Kenan Erzurum, director of the Library and Documentation Center of the Bahcesehir University, and officials responsible for periodicals for their supplying the originals of historical publications. We also thank Elif Tugce Kaplan, Tugba Kaplan, and Zeynep Sude Kaplan for their outstanding efforts in the technical artwork of the illustrations.


  1. 1.
    Patey D, Williams ES (1956) Pilonidal sinus of the umbilicus. Lancet 271(6937):281–282Google Scholar
  2. 2.
    Warren J (1854) Abscess, containing hair, on the nates. Am J Med Sci 28:113Google Scholar
  3. 3.
    Aird I (1952) Pilonidal sinus of the axilla. Br Med J 1(4764):902–903Google Scholar
  4. 4.
    Kaplan M, Ozcan O, Kaplan FC, Yalcin HC, Salman B (2016) Conservative vs. surgical interventions for umbilical pilonidal sinus: a multicenter, double-blind, prospective, randomized clinical trial. J Am Coll Surg 222(5):878–889Google Scholar
  5. 5.
    Kaplan M, Kaplan ET, Kaplan T, Kaplan FC (2017) Umbilical pilonidal sinus, an underestimated and little-known clinical entity: report of two cases. Am J Case Rep 18:2–5Google Scholar
  6. 6.
    Coskun A, Bulus H, Faruk Akinci O, Ozgonul A (2011) Etiological factors in umbilical pilonidal sinus. Indian J Surg 73(1):54–57Google Scholar
  7. 7.
    Kareem T (2013) Outcomes of conservative treatment of 134 cases of umbilical pilonidal sinus. World J Surg 37(2):313–317Google Scholar
  8. 8.
    McClenathan JH (2000) Umbilical pilonidal sinus. Can J Surg 43(3):225Google Scholar
  9. 9.
    Eryilmaz R, Sahin M, Okan I, Alimoglu O, Somay A (2005) Umbilical pilonidal sinus disease: predisposing factors and treatment. World J Surg 29(9):1158–1160Google Scholar
  10. 10.
    Colapinto ND (1977) Umbilical pilonidal sinus. Br J Surg 64(7):494–495Google Scholar
  11. 11.
    Hodges R (1880) Pilonidal sinus. Boston Med Surg J 103:485–586Google Scholar
  12. 12.
    Cullen TS (1916) Embryology, anatomy, and diseases of the umbilicus together with diseases of the urachus. W.B. Saunders Company, Philadelphia/LondonGoogle Scholar
  13. 13.
    Hegazy AA (2016) Anatomy and embryology of umbilicus in newborns: a review and clinical correlations. Front Med 10(3):271–277Google Scholar
  14. 14.
    Clery A, Clery A (1963) Pilonidal disease of the umbilicus. Br J Surg 50:666–668Google Scholar
  15. 15.
    Abdelnour A, Aftimos G, Elmasri H (1994) Conservative surgical treatment of 27 cases of umbilical pilonidal sinus. J Med Liban 42(3):123–125Google Scholar
  16. 16.
    Haj M, Cohen I (2004) Umbilical pilonidal sinus: ambulatory surgical technique. Ambul Surg 11(1):37–39Google Scholar
  17. 17.
    Patey DH, Scarff RW (1948) Pilonidal sinus in a barber’s hand with observations on postanal pilonidal sinus. Lancet (London, England) 2(6514):13Google Scholar
  18. 18.
    Brearley R (1955) Pilonidal sinus; a new theory of origin. Br J Surg 43(177):62–68Google Scholar
  19. 19.
    Karydakis GE (1992) Easy and successful treatment of pilonidal sinus after explanation of its causative process. Aust N Z J Surg 62(5):385–389Google Scholar
  20. 20.
    Doll D, Friederichs J, Dettmann H, Boulesteix A-L, Duesel W, Petersen S (2008) Time and rate of sinus formation in pilonidal sinus disease. Int J Colorectal Dis 23(4):359–364Google Scholar
  21. 21.
    Doll D, Matevossian E, Wietelmann K, Evers T, Kriner M, Petersen S (2009) Family history of pilonidal sinus predisposes to earlier onset of disease and a 50% long-term recurrence rate. Dis Colon Rectum 52(9):1610–1615Google Scholar
  22. 22.
    Vargas-Diez E, Delgado Y, Ibanez S, Garcia-Diez A (2010) “Unveiling the umbilicus”: a simple technique to approach examination and excision of umbilical cutaneous lesions. Dermatol Surg 36(3):392–394Google Scholar
  23. 23.
    Mallin K, Pemminati S (2016) Unique application of cryocone to diagnose umbilical pilonidal cyst. J Clin Diagn Res 10(9):LD01–LD02Google Scholar
  24. 24.
    Ponten JB, Ponten JEH, Luyer MDP, Nienhuijs SW (2016) An umbilical surprise: a collective review on umbilical pilonidal sinus: an uncommon alternative diagnosis in common umbilical symptoms. Hernia 20(4):497–504Google Scholar
  25. 25.
    Heller DS (2012) Lesions of the umbilicus: what the minimally invasive gynecologic surgeon needs to know about the belly button. J Minim Invasive Gynecol 19(6):680–683Google Scholar
  26. 26.
    Kaplan M, Kaplan ET, Kaplan T, Kaplan FC (2017) Letter to the editor: “umbilical pilonidal sinus: a report of two cases and recent update of literature”. J Clin Diagn Res 11(2):PL01Google Scholar
  27. 27.
    Urquhart-Hay D (1966) Pilonidal sinus or hair granuloma of the umbilicus? Report of a case. N Z Med J 65(412):984–985Google Scholar
  28. 28.
    Allegaert WJ (1967) Pilonidal sinus of the umbilicus. Br J Clin Pract 21(4):201Google Scholar
  29. 29.
    Hassan MA (1969) Simultaneous occurrence of umbilical and postanal pilonidal sinus. S Afr Med J 43(4):79–80Google Scholar
  30. 30.
    Dixit SP (1976) Pilonidal sinus of the umbilicus. Can J Surg 19(5):422–426Google Scholar
  31. 31.
    Gupta S, Gupta S (1981) Pilonidal sinus of the umbilicus with urachal adenoma. Trop Geogr Med 33(4):393–396Google Scholar
  32. 32.
    Gupta S, Sikora S, Singh M, Sharma L (1990) Pilonidal disease of the umbilicus--a report of two cases. Jpn J Surg 20(5):590–592Google Scholar
  33. 33.
    Kasiakou SK, Rafailidis PI, Rosmarakis ES, Falagas ME (2004) Recurrent omphalitis in adults. Scand J Gastroenterol 39(10):1021–1024Google Scholar
  34. 34.
    Eby CS, Jetton RL (1972) Umbilical pilonidal sinus. Arch Dermatol 106(6):893Google Scholar
  35. 35.
    Kaplan M, Kaplan F (2016) Comment to “An umbilical surprise: a collective review on umbilical pilonidal sinus”. J. B. Ponten, J. E. H. Ponten, M. D. P. Luyer, S. W. Nienhuijs. Hernia 21(3):493–494Google Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Mehmet Kaplan
    • 1
    • 2
  • Huseyin Cahit Yalcin
    • 3
  • Onder Ozcan
    • 4
  • Fatma Cigdem Kaplan
    • 5
  1. 1.Department of General SurgeryBahcesehir University (BAU), School of MedicineIstanbulTurkey
  2. 2.Department of General SurgeryNCR International HospitalGaziantepTurkey
  3. 3.Department of General SurgeryHarran University, School of MedicineSanliurfaTurkey
  4. 4.Department of General SurgeryMuglaSitkiKocman University, School of MedicineMuglaTurkey
  5. 5.Family Physician25-Aralik Family Health Center, Ministry of HealthGaziantepTurkey

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