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Pilonidal abscess

MedGen UID:
782463
•Concept ID:
C3537055
•
Pathologic Function
Synonyms: Abscess of skin and/or subcutaneous tissue caused by ingrown hair; Sacrococcygeal fistula
SNOMED CT: Pilonidal abscess (866000008); Abscess of skin and/or subcutaneous tissue caused by ingrown hair (866000008)
 
HPO: HP:0010771

Definition

A hair-containing cyst or sinus usually in the coccygeal region. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVPilonidal abscess

Professional guidelines

PubMed

German National Guideline on the management of pilonidal disease: update 2020.
Iesalnieks I, Ommer A, Herold A, Doll D
Langenbecks Arch Surg 2021 Dec;406(8):2569-2580. Epub 2021 May 5 doi: 10.1007/s00423-020-02060-1. PMID: 33950407Free PMC Article
Abscess Management: An Evidence-Based Review for Emergency Medicine Clinicians.
Menegas S, Moayedi S, Torres M
J Emerg Med 2021 Mar;60(3):310-320. Epub 2020 Dec 6 doi: 10.1016/j.jemermed.2020.10.043. PMID: 33298356
German national guideline on the management of pilonidal disease.
Iesalnieks I, Ommer A, Petersen S, Doll D, Herold A
Langenbecks Arch Surg 2016 Aug;401(5):599-609. Epub 2016 Jun 16 doi: 10.1007/s00423-016-1463-7. PMID: 27311698

Recent clinical studies

Etiology

Abscess Management: An Evidence-Based Review for Emergency Medicine Clinicians.
Menegas S, Moayedi S, Torres M
J Emerg Med 2021 Mar;60(3):310-320. Epub 2020 Dec 6 doi: 10.1016/j.jemermed.2020.10.043. PMID: 33298356
Short-term outcomes of endoscopic pilonidal sinus treatment.
Kalaiselvan R, Liyanage A, Rajaganeshan R
Ann R Coll Surg Engl 2020 Feb;102(2):94-97. Epub 2019 Aug 5 doi: 10.1308/rcsann.2019.0097. PMID: 31379189Free PMC Article
Aspiration for acute pilonidal abscess-a cohort study.
Lasithiotakis K, Aghahoseini A, Volanaki D, Peter M, Alexander D
J Surg Res 2018 Mar;223:123-127. Epub 2017 Nov 17 doi: 10.1016/j.jss.2017.09.051. PMID: 29433863
Endoscopic pilonidal abscess treatment: a novel approach for the treatment of pilonidal abscess.
Jain Y, Javed MA, Singh S, Rout S, Joshi H, Rajaganeshan R
Ann R Coll Surg Engl 2017 Feb;99(2):134-136. Epub 2016 Aug 23 doi: 10.1308/rcsann.2016.0260. PMID: 27551895Free PMC Article
Does pilonidal abscess heal quicker with off-midline incision and drainage?
Webb PM, Wysocki AP
Tech Coloproctol 2011 Jun;15(2):179-83. Epub 2011 Apr 29 doi: 10.1007/s10151-011-0684-6. PMID: 21533783

Diagnosis

Anorectal Emergencies.
Drezdzon MK, Peterson CY
Surg Clin North Am 2023 Dec;103(6):1153-1170. Epub 2023 Jul 21 doi: 10.1016/j.suc.2023.05.014. PMID: 37838461
Abscess Management: An Evidence-Based Review for Emergency Medicine Clinicians.
Menegas S, Moayedi S, Torres M
J Emerg Med 2021 Mar;60(3):310-320. Epub 2020 Dec 6 doi: 10.1016/j.jemermed.2020.10.043. PMID: 33298356
Short-term outcomes of endoscopic pilonidal sinus treatment.
Kalaiselvan R, Liyanage A, Rajaganeshan R
Ann R Coll Surg Engl 2020 Feb;102(2):94-97. Epub 2019 Aug 5 doi: 10.1308/rcsann.2019.0097. PMID: 31379189Free PMC Article
Pilonidal abscess of the breast.
Keighley J, Nadim A, Howlett D
BMJ Case Rep 2019 Mar 31;12(3) doi: 10.1136/bcr-2018-227381. PMID: 30936332Free PMC Article
Skin and soft-tissue infections caused by Actinobaculum schaalii: report of two cases and literature review.
Tena D, Fernández C, Lago MR, Arias M, Medina MJ, Sáez-Nieto JA
Anaerobe 2014 Aug;28:95-7. Epub 2014 Jun 9 doi: 10.1016/j.anaerobe.2014.05.009. PMID: 24923266

Therapy

Pilonidal abscess of the breast.
Keighley J, Nadim A, Howlett D
BMJ Case Rep 2019 Mar 31;12(3) doi: 10.1136/bcr-2018-227381. PMID: 30936332Free PMC Article
Aspiration for acute pilonidal abscess-a cohort study.
Lasithiotakis K, Aghahoseini A, Volanaki D, Peter M, Alexander D
J Surg Res 2018 Mar;223:123-127. Epub 2017 Nov 17 doi: 10.1016/j.jss.2017.09.051. PMID: 29433863
Endoscopic pilonidal abscess treatment: a novel approach for the treatment of pilonidal abscess.
Jain Y, Javed MA, Singh S, Rout S, Joshi H, Rajaganeshan R
Ann R Coll Surg Engl 2017 Feb;99(2):134-136. Epub 2016 Aug 23 doi: 10.1308/rcsann.2016.0260. PMID: 27551895Free PMC Article
German national guideline on the management of pilonidal disease.
Iesalnieks I, Ommer A, Petersen S, Doll D, Herold A
Langenbecks Arch Surg 2016 Aug;401(5):599-609. Epub 2016 Jun 16 doi: 10.1007/s00423-016-1463-7. PMID: 27311698
Pilonidal disease.
Isbister WH, Prasad J
Aust N Z J Surg 1995 Aug;65(8):561-3. doi: 10.1111/j.1445-2197.1995.tb01695.x. PMID: 7661795

Prognosis

Short-term outcomes of endoscopic pilonidal sinus treatment.
Kalaiselvan R, Liyanage A, Rajaganeshan R
Ann R Coll Surg Engl 2020 Feb;102(2):94-97. Epub 2019 Aug 5 doi: 10.1308/rcsann.2019.0097. PMID: 31379189Free PMC Article
Pilonidal disease in a military population: how far have we really come?
Fitzpatrick EB, Chesley PM, Oguntoye MO, Maykel JA, Johnson EK, Steele SR
Am J Surg 2014 Jun;207(6):907-14. Epub 2013 Oct 26 doi: 10.1016/j.amjsurg.2013.07.038. PMID: 24239526
Does pilonidal abscess heal quicker with off-midline incision and drainage?
Webb PM, Wysocki AP
Tech Coloproctol 2011 Jun;15(2):179-83. Epub 2011 Apr 29 doi: 10.1007/s10151-011-0684-6. PMID: 21533783
Simple and effective surgical treatment of pilonidal sinus: asymmetric excision and primary closure using suction drain and subcuticular skin closure.
Akinci OF, Coskun A, Uzunköy A
Dis Colon Rectum 2000 May;43(5):701-6; discussion 706-7. doi: 10.1007/BF02235591. PMID: 10826434
Prognosis after simple incision and drainage for a first-episode acute pilonidal abscess.
Jensen SL, Harling H
Br J Surg 1988 Jan;75(1):60-1. doi: 10.1002/bjs.1800750122. PMID: 3337954

Clinical prediction guides

Negative pressure wound therapy following excision of pilonidal sinus disease: A retrospective review.
Hannan E, Harding T, Feizal H, Martin S
Colorectal Dis 2021 Nov;23(11):2961-2966. Epub 2021 Sep 12 doi: 10.1111/codi.15890. PMID: 34455675
Early versus delayed endoscopic treatment of acute pilonidal abscess: a propensity score-matched analysis.
Manigrasso M, Velotti N, Sosa Fernandez LM, Vertaldi S, Maione F, Gennarelli N, Schettino P, Musella M, De Palma GD, Milone M
Int J Colorectal Dis 2021 Feb;36(2):339-345. Epub 2020 Oct 3 doi: 10.1007/s00384-020-03767-9. PMID: 33011845
Endoscopic pilonidal abscess treatment: a novel approach for the treatment of pilonidal abscess.
Jain Y, Javed MA, Singh S, Rout S, Joshi H, Rajaganeshan R
Ann R Coll Surg Engl 2017 Feb;99(2):134-136. Epub 2016 Aug 23 doi: 10.1308/rcsann.2016.0260. PMID: 27551895Free PMC Article
Learning Curve for Pilonidal Sinus Surgery: The Best Option for Budding Surgeons.
Gupta A, Anand S, Mehrotra S, Khidtta K
World J Surg 2017 Feb;41(2):615-619. doi: 10.1007/s00268-016-3669-9. PMID: 27464913
Sacrococcygeal foreign body progressing with pilonidal sinus clinical picture: report of a case.
Özdemir ZÜ, Özdemir H, Şahiner İT, Şenol M
J Emerg Med 2013 Dec;45(6):e205-7. Epub 2013 Jul 18 doi: 10.1016/j.jemermed.2013.05.022. PMID: 23871483

Recent systematic reviews

Healing by primary versus secondary intention after surgical treatment for pilonidal sinus.
Al-Khamis A, McCallum I, King PM, Bruce J
Cochrane Database Syst Rev 2010 Jan 20;2010(1):CD006213. doi: 10.1002/14651858.CD006213.pub3. PMID: 20091589Free PMC Article
Healing by primary versus secondary intention after surgical treatment for pilonidal sinus.
McCallum I, King PM, Bruce J
Cochrane Database Syst Rev 2007 Oct 17;(4):CD006213. doi: 10.1002/14651858.CD006213.pub2. PMID: 17943897

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