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

Abstract

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