Wysocki - Morphology and terminology c · Principles and Practice of Surgery for the Colon, Rectum,...
Transcript of Wysocki - Morphology and terminology c · Principles and Practice of Surgery for the Colon, Rectum,...
PILONIDAL SINUS
Peter WysockiGeneral Surgeon
Logan HospitalSunnybank Private Hospital, Brisbane, Australia
MorphologyTerminology
Patey and Scarff in 1946 reported a pilonidal sinus in a 31 year old barber’s hand which resulted in congenital theory being abandoned
PATEY DH, SCARFF RW. Pathology of postanal pilonidal sinus; its bearing on treatment. Lancet. 1946 Oct 5;2(6423):484‐6.
ACQUIRED
2nd International Pilonidal Sinus Disease Conference28th September 2019, Vienna
2nd International Pilonidal Sinus Disease Conference28th September 2019, Vienna
TERMINOLOGY
2nd International Pilonidal Sinus Disease Conference28th September 2019, Vienna
Primary Unhealed Recurrent
2nd International Pilonidal Sinus Disease Conference28th September 2019, Vienna
PRIMARY: midline only
PRIMARY: secondary
UNHEALED
RECURRENT
?PILONIDAL and HIDRADENITIS
1. loose hair enters
2. hair + seropurulentdischarge
Principles and Practice of Surgery for the Colon, Rectum, and Anus, Third Edition Philip H . Gordon and Santhat Nivatvongs. CRC Press 2007 Print ISBN: 978‐0‐8247‐2961‐5eBook ISBN: 978‐1‐4200‐1799‐1
MECHANISM
Karydakis, 1992
Tech Coloproctol (2017) 21:905–906https://doi.org/10.1007/s10151‐017‐1702‐0
Due to friction hair migrates in leading with the root end
Page BH. The Entry of Hair into a Pilonidal Sinus. Br J Surg. 1969 Jan;56(1):32.
International Journal of Cosmetic Science, 2015, 37, 312–320 doi: 10.1111/ics.12201
Hair x
Forcex
Vulnerability
2nd International Pilonidal Sinus Disease Conference28th September 2019, Vienna
Source of hair in 14 pilonidal sinuses: – 71% head– 64% buttocks– 57% lower back
2nd International Pilonidal Sinus Disease Conference28th September 2019, Vienna
2nd International Pilonidal Sinus Disease Conference28th September 2019, Vienna
CLASSIFICATION
TREATMENT
2nd International Pilonidal Sinus Disease Conference28th September 2019, Vienna
VIENNA September 28, 2019QUESTIONS ?