Pilonidal Cyst and Abscess

Pilonidal disease may manifest itself as a chronically draining sinus or fistula at the base of the spine in the interglu-teal crease 5 to 10 cm from the anus. Pilonidal cysts can also become infected and may lead to extensive presacral abscess formation. Multiple hair shafts may be seen within the cyst. Incision and drainage or an elliptic incision under local anesthesia over the sinus track is performed. Drainage is the preferred office management technique and is similar to standard abscess treatment. Packing of the wound should be done, and referral is recommended for excision of the extensive presacral complex. Recurrence is common without excision.

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