What is the clinical history of pilonidal cyst and sinus?

Updated: May 20, 2019
  • Author: Alex Koyfman, MD; Chief Editor: Gil Z Shlamovitz, MD, FACEP  more...
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Pilonidal disease can present in a couple of different disease states and may be asymptomatic, but the most common form seen in the ED is a painful, swollen lesion in the sacrococcygeal region about 4-5 cm posterior to the anal orifice. At times, spontaneous drainage may have occurred prior to presentation to the clinician. Patients may present with intermittent swelling and drainage, including purulent, mucoid, or bloody fluid from the area. Chronic pilonidal disease often manifests as recurrent or persistent drainage and pain.

Occasionally, a history of trauma is recalled, and the patient may state that a similar lesion occurred in that area before, for which the patient may have had a primary incision and drainage or other definitive care prior to this presentation. [7] Given most patients are young and healthy, other comorbidities are not common, and review of systems is often negative, including fever and chills.

There is no known preponderance of this disease in smokers or alcohol or drug abusers.

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