Pilonidal sinus fistulography

Case contributed by Bahman Rasuli
Diagnosis certain

Presentation

Palpable mass at intergluteal cleft with drainage.

Patient Data

Age: 20 years
Gender: Male
Fluoroscopy

Injection of contrast via the orifice of purulent discharge showed opacification of the intergluteal pilonidal sinus cavity measuring about 30*50 mm superficial to the sacrum within the subcutaneous tissue. 

No evidence of obvious contrast extravasation into the anal canal or rectum.

Case Discussion

Pilonidal sinus results from a skin and subcutaneous tissue infection, typically occurring at or near the upper part of the Intergluteal cleft. While it classically occurs in the intergluteal region, it can rarely occur at other sites. Intergluteal pilonidal sinus can be clinically difficult to differentiate from a perianal fistula.

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