UPSC Aspirant Diagnosed With A Rare World War II Ailment That Affected Soldiers, All About The Disease!

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A young UPSC aspirant in Delhi has been diagnosed with a rare condition from World War II. The patient, who is now recovering, underwent surgery for the ailment.

The 21-year-old civil service candidate was found to have pilon sinus at a private hospital. This painful condition, also known as "Jeepers Bottom," involves recurring pus formation near the tailbone due to broken hair accumulating in a subcutaneous cavity.

It was first identified during World War II among soldiers.

In an official statement, Sir Ganga Ram Hospital said that the aspirant likely developed this condition from prolonged sitting while studying on library chairs. Tarun Mittal from the Department of Laparoscopic and Laser Surgery explained that over time, the student experienced painful swelling in his buttock cleft.

The situation worsened, leading to increased pus discharge and severe pain, eventually confining him to bed. "Considering his condition, we opted for EPSiT (Endoscopic Pilonidal Sinus Tract Ablation Surgery) as an ideal solution for the student so he could recover quickly and get back to his studies as soon as possible," said Mittal, who performed the surgery.

Let us know what a pilonidal sinus is, why it occurs, and how it can be treated for those who might be affected or are simply curious about the condition.

What Is A Pilonidal Sinus?

A pilonidal sinus (PNS), also known as 'Jeepers Bottom', is essentially a small tunnel or tract that forms under the skin at the top of the buttocks, near the tailbone. This tunnel can become filled with hair, skin debris, and other matter, leading to the development of a cyst or abscess.

While the exact cause of pilonidal sinuses isn't entirely understood, it is believed that ingrown hairs play a significant role in their formation. The condition can range from a small, asymptomatic pit to a painful abscess that requires medical intervention.

Symptoms Of Pilonidal Sinus

The symptoms of a pilonidal sinus can vary depending on the severity of the condition. Some people may not experience any symptoms, while others may suffer from significant discomfort. Here are the most common symptoms associated with a pilonidal sinus:

1. Pain and Discomfort: The most noticeable symptom is pain or tenderness at the top of the buttocks, particularly when sitting or moving from sitting to standing.
2. Swelling and Redness: The area around the sinus can become swollen and red, indicating inflammation.
3. Discharge: A pilonidal sinus can cause a foul-smelling discharge of pus or blood. This discharge is often a sign of infection.
4. Fever: In cases where the sinus becomes infected, a person might develop a fever as their body attempts to fight the infection.
5. Recurrence: Pilonidal sinuses are known for recurring, especially if they are not treated properly. Repeated infections can lead to chronic pain and discomfort.

Causes Of Pilonidal Sinus

The exact cause of pilonidal sinus formation is not completely understood, but several factors are believed to contribute to its development. These include:

1. Ingrown Hairs: The most widely accepted theory is that a pilonidal sinus forms due to ingrown hairs. Hair follicles can become trapped under the skin, leading to the formation of a cyst or sinus.
2. Friction and Pressure: Activities that involve prolonged sitting, cycling, or other forms of pressure on the buttocks can increase the risk of developing a pilonidal sinus. Friction can cause hair to penetrate the skin, leading to inflammation and cyst formation.
3. Trauma: An injury or trauma to the area can sometimes lead to the development of a pilonidal sinus. This could be due to a direct impact or continuous irritation of the skin.
4. Hormonal Changes: Pilonidal sinuses are more common during puberty, which suggests that hormonal changes may play a role in their development.
5. Genetics: There is some evidence to suggest that pilonidal sinuses may run in families, indicating a possible genetic predisposition.

Risk Factors Of Polonidal Sinus

Certain factors can increase the likelihood of developing a pilonidal sinus. These include:

1. Gender: Pilonidal sinuses are more common in men than in women, possibly due to differences in body hair distribution.
2. Age: The condition is most prevalent in young adults, particularly those between the ages of 15 and 35.
3. Obesity: Being overweight can increase the risk of developing a pilonidal sinus due to additional pressure on the buttocks.
4. Sedentary Lifestyle: A lack of physical activity, especially sitting for prolonged periods, can increase the risk of pilonidal sinus formation.
5. Hair Type: Individuals with coarse, curly hair may be more susceptible to ingrown hairs, which can lead to the development of a pilonidal sinus.

Diagnosis Of Polonidal Sinus

Diagnosing a pilonidal sinus is typically straightforward and can be done through a physical examination. A healthcare provider will examine the area near the tailbone for signs of swelling, redness, and discharge.

In some cases, additional tests may be required to rule out other conditions or to assess the extent of the infection. These tests might include:

• Ultrasound: An ultrasound can help determine the size and extent of the sinus or cyst.
• CT Scan or MRI: In rare cases, imaging studies such as a CT scan or MRI may be used to assess deeper tissue involvement.

Treatment Options For Polonidal Sinus

Treatment for a pilonidal sinus depends on the severity of the condition. In mild cases, home care and lifestyle changes may be sufficient to manage the symptoms. However, more severe cases often require medical or surgical intervention.

In recurrent or severe cases, surgery may be required to remove the sinus entirely. This procedure is more invasive and involves the removal of the sinus tract along with any surrounding tissue that might be infected or prone to future problems.

Recovery from surgery may take several weeks, and careful post-operative care is necessary to prevent recurrence.

EPSiT, A Minimally Invasive Surgery

"The scope is introduced into the tract and thoroughly visualised for hair, which is removed with grasping forceps. After removing all the hair and debris, a cautery is introduced to burn the entire tract, and then a brush is used to curtail the tract. It took almost 30 minutes to remove all the hair from the cavity," said Mittal while sharing the details about the procedure.

This latest minimally invasive endoscopic technique has significantly improved patient recovery and comfort. Patients can walk immediately after the operation, enhancing their overall recovery experience.

During EPSiT surgery, an endoscope is inserted into the sinus tract to inspect it thoroughly. Hair is removed using grasping forceps, followed by cauterisation of the entire tract to eliminate any remaining debris. A brush is then used for curettage.

Prevention Of Polonidal Sinus

Preventing a pilonidal sinus can be challenging, especially if you have risk factors that predispose you to the condition. However, there are several steps you can take to reduce your risk:

1. Maintain Good Hygiene: Keeping the area clean and dry can help prevent the formation of a pilonidal sinus. Regular washing and drying, especially after sweating, can reduce the risk of infection.
2. Avoid Prolonged Sitting: If possible, try to minimize prolonged sitting, especially on hard surfaces. Taking regular breaks to stand and move around can reduce pressure on the buttocks.
3. Weight Management: Maintaining a healthy weight can help reduce the pressure on the tailbone area, thereby lowering the risk of pilonidal sinus formation.
4. Hair Removal: In some cases, removing hair from the area can help prevent the formation of ingrown hairs. This can be done through shaving, waxing, or laser hair removal.

Whether through home care, medical treatment, or surgical intervention, most people can find relief from a pilonidal sinus and take steps to prevent its recurrence. If you suspect you have a pilonidal sinus, it is essential to seek medical advice early to avoid complications and ensure the best possible outcome.

Disclaimer: The information provided in this article is for general informational and educational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or a qualified healthcare provider with any questions you may have regarding a medical condition.