Sacrococcygeal pilonidal cyst with the disease onset as an anterior perianal abscess: a clinical case

Abstract

The aim. To analyze the clinical case of surgical treatment of a patient with a pilonidal cyst (PC) of the sacrococcygeal area, which manifested as an anterior perianal abscess, and to justify the need for an in-depth differential and diagnostic search in patients with corresponding clinical manifestations of perianal pathology. Description of a clinical case. The article describes a clinical case of successful treatment of a 24-year-old patient with a pilonidal cyst of the sacrococcygeal area and a purulent secondary fistula that mimicked a perianal abscess with an incomplete external fistula of the rectum. Data are given on the step-by-step performance of the diagnostic process and the choice of optimal surgical treatment tactics. Results and discussion. The described clinical case is interesting for specialists and its detailed coverage due to: a) the presented atypical course of PC; b) selected diagnostic tactics; c) the selected method of operative treatment of the patient. The points mentioned above are described in detail in the section, with coverage and visualization of possible alternative options for the patient's diagnosis and the use of various tactics for surgical treatment. Conclusions. Conducting an extended differential diagnostic search using additional instrumental imaging methods is justified in patients with pilonidal disease with an atypical or blurred course. Performing a complete perioperative set of examinations allows for choosing the correct surgical tactics for treating such patients. The use of a full-fledged invasive examination of the perianal area using methods of regional or general anesthesia is reasonably justified in case of suspicion of insufficient informativeness of clinical-instrumental, laboratory, and imaging methods of examination