A Rare Case of Umbilical Pilonidal Sinus

Abstract

 The umbilical pilonidal sinus (UPS) is a rare condition that presents unique diagnostic challenges due to its uncommon nature. Unlike the more common pilonidal sinuses found near the buttocks, UPS can occur in various atypical locations, including the breast, spaces between ngers, armpit, and belly button. UPS is a relatively uncommon subtype, accounting for only about 0.6% of all pilonidal diseases. The diagnosis of UPS can be challenging, as it may not initially be suspected due to its rarity and unusual presentation. Clinicians must maintain a high index of suspicion, especially in patients with predisposing factors for pilonidal disease, such as being young, male, obese, hairy, and having poor skin hygiene. Although UPS is rare, awareness of this condition among healthcare providers is crucial for prompt diagnosis and appropriate management. Early recognition can help prevent complications and improve outcomes for patients with UPS. Further research is needed to better understand the pathogenesis and optimal management strategies for this rare but clinically important condition. Several risk factors for UPS overlap with those for pilonidal cysts in the buttock cleft, including being young, male, obese, hairy, and having poor skin hygiene. However, the presentation of UPS can differ, requiring a high index of suspicion for accurate diagnosis. We recently encountered a case involving a teenage boy with an umbilical pilonidal sinus that initially presented as a sinus near the belly button. Upon further investigation using imaging and surgical exploration, a hair-containing sinus was identied within the umbilicus. Increasing awareness of UPS among pediatric surgeons is essential for prompt diagnosis and treatment. This awareness can lead to quicker identication of the condition, potentially avoiding unnecessary imaging tests that may not provide conclusive results. Understanding the distinct features of UPS is crucial for its effective identication and management.