Anal, perianal, perineal and sacrococcygeal sinuses

Abstract

In accordance with the accepted definitions of “sinus” and “fistula” an attempt has been made to indicate those lesions which are true fistulas and those which are true sinuses in the anal, perianal, perineal and sacrococcygeal regions. Inasmuch as the great majority of socalled “draining sinuses” in the anal, perianal and perineal skin are in reality the secondary openings of true anal fistulas, an effort has been made to clarify the pathogenesis of anal fistula. It is hoped that a proper understanding of this mechanism will lead to more accurate diagnosis and to adequate management. Pilonidal cyst is the most common “developmental” lesion dorsal to the sacrum and coccyx. The essential differential diagnostic features of anal, perianal, perineal and sacrococcygeal sinuses have been briefly stated.