Wednesday, July 4, 2018

Jeep bottom!

Imagine that you were a driver in the World war. You drive a jeep, fight for your country and do all that is required of you and make yourself feel proud. You are tired at the end of the day and just want to take rest. Suddenly you find that fluid is leaking from the base of your spine and it is foul smelling. You think that it is just sweat, forget all about it and take rest.
In a few days, the fluid leak increases and then suddenly it becomes an abscess (pus filled). It is throbbing, painful and unbearable. You take some antibiotics and forget all about it.  It keeps coming back again and again and then you decide to do something about it. You don’t know which doctor to consult. You search the internet and think that it is ‘piles’.
I met a patient a few days ago in my clinic who did not know which doctor to approach for a pilonidal sinus. He knew the diagnosis because he had done a little bit of research on the internet. That made me dive headlong into the topic.
Pilus means hair and nidus means nest and pilonidal sinus means nest of hair. Pilonidal sinus disease was first described in 1833 and attained fame due to its presence in soldiers during World War II. During this time, it was known as “Jeep Disease”. Hair goes through the skin, forms a track and stays until it is removed.
There are several treatments for this condition. It can be excised and left to heal by itself or it can be closed primarily. Several types of flaps can be planned for the primary closure.
Since the disease happens in young individuals, cosmesis has to be considered. Time away from work or school also plays a role.

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