Role of Ultrasonography in Evaluation of Pilonidal Disease

Abstract

Aim: Pilonidal disease (PD) generally occurs in the sacrococcygeal region and physical examination (PE) is the main diagnostic method. However, imaging methods such as ultrasonography (USG) may be necessary to evaluate PD in some cases. The aim of this study was to evaluate the use of USG in PD. Method: PD patients who underwent preoperative superficial USG between January 2012 and December 2013 were evaluated retrospectively. Age, sex, body mass index (BMI), duration of complaints, distance from anal verge, number of inactive or active sinus orifices, anesthesia type, and PD dimensions and distal and proximal borders in PE, USG, and postoperative exploration (EXP) were evaluated. T-test and Pearson’s correlation were used for statistical analysis. Results: Forty patients were included in the study. All patients were male (100%), mean age was 22.82±2.77 years, and mean BMI was 24.96±2.35 kg/cm2. Surgery was conducted under local anesthesia for 72.5% of the patients. Mean PD dimensions on USG were significantly larger in patients operated under spinal anesthesia (p=0.01). The correlation of dimensions between PE and EXP was 0.72 (good) (p=0.0001) and correlation between USG and EXP was 0.51 (moderately good) (p=0.001). The correlation of distal and proximal borders between PE and EXP was 0.564 (good) and between USG and EXP was 0.368 (moderate) (p=0.0001, p=0.02 respectively). Conclusion: Physical examination is a simple and highly accurate diagnostic modality for determining dimensions and borders of PD. USG dimensions are beneficial for determining suitable anesthesia type. Hydrogen peroxide-enhanced USG or magnetic resonance imaging can be used for advanced evaluation of PD.

Keywords

• Pilonidal disease
• physical examination
• ultrasonography
• anesthesia