A hairy cavity: endoscopic therapy of a presacral recurrence of a complex pilonidal sinus
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A hairy cavity: endoscopic therapy of a presacral recurrence of a complex pilonidal sinus. / Noorah, A; Bellon, E; Izbicki, J R; Tachezy, M; Kantowski, M.
In: INT J COLORECTAL DIS, Vol. 34, No. 10, 10.2019, p. 1791-1794.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - A hairy cavity: endoscopic therapy of a presacral recurrence of a complex pilonidal sinus
AU - Noorah, A
AU - Bellon, E
AU - Izbicki, J R
AU - Tachezy, M
AU - Kantowski, M
PY - 2019/10
Y1 - 2019/10
N2 - BACKGROUND: Recently, minimally invasive techniques to avoid radical excisions of the pilonidal sinus with long-lasting secondary wound healing were developed. We describe a rare case of an intrapelvic, pararectal recurrence of a pilonidal sinus, who was innovatively treated with flexible endoscopy.CASE PRESENTATION: A 43-year-old Caucasian man presented with an intrapelvic, pararectal recurrence of a primarily wide-stretched pilonidal sinus, originally located in the sacrococcygeal region and spreading laterally to the gluteal region and intrapelvic to the presacral area. No connection to the bowel was evident. Up until presentation in the endoscopic department, a total of five attempts of surgical resection were performed, always confirming the diagnosis of a pilonidal sinus. Endoscopic therapy consisted of a combination of debridement, laser ablation and endoscopic vacuum therapy. After completion of APC and VAC therapy, the patient irrigated the abscess cavity for a further 2 weeks with a rinsing syringe. The resulting deep scar at the gluteal fistula was resected after secondary wound healing was completed. Two years after the end of the therapy, no recurrence was evident.CONCLUSION: Flexible endoscopy is, with its multiple therapeutic applications, an effective tool even in very complex inflammatory fistula and abscesses. Correctly indicated, it is with its minimally invasive character an excellent alternative to open surgical approaches.
AB - BACKGROUND: Recently, minimally invasive techniques to avoid radical excisions of the pilonidal sinus with long-lasting secondary wound healing were developed. We describe a rare case of an intrapelvic, pararectal recurrence of a pilonidal sinus, who was innovatively treated with flexible endoscopy.CASE PRESENTATION: A 43-year-old Caucasian man presented with an intrapelvic, pararectal recurrence of a primarily wide-stretched pilonidal sinus, originally located in the sacrococcygeal region and spreading laterally to the gluteal region and intrapelvic to the presacral area. No connection to the bowel was evident. Up until presentation in the endoscopic department, a total of five attempts of surgical resection were performed, always confirming the diagnosis of a pilonidal sinus. Endoscopic therapy consisted of a combination of debridement, laser ablation and endoscopic vacuum therapy. After completion of APC and VAC therapy, the patient irrigated the abscess cavity for a further 2 weeks with a rinsing syringe. The resulting deep scar at the gluteal fistula was resected after secondary wound healing was completed. Two years after the end of the therapy, no recurrence was evident.CONCLUSION: Flexible endoscopy is, with its multiple therapeutic applications, an effective tool even in very complex inflammatory fistula and abscesses. Correctly indicated, it is with its minimally invasive character an excellent alternative to open surgical approaches.
U2 - 10.1007/s00384-019-03366-3
DO - 10.1007/s00384-019-03366-3
M3 - SCORING: Journal article
C2 - 31435733
VL - 34
SP - 1791
EP - 1794
JO - INT J COLORECTAL DIS
JF - INT J COLORECTAL DIS
SN - 0179-1958
IS - 10
ER -