Pilonidal disease in children: some links of etiopathogenesis of the disease (clinical observation)
DOI:
https://doi.org/10.15574/PS.2020.67.85Keywords:
pilonidal disease, children, etiology, pathogenesis, clinical caseAbstract
Pilonidal cyst of the tailbone is a common purulent-inflammatory disease that occurs in children of different age groups, often in adolescence in the form of an acute abscess. The disease is prone to recurrent course and requires radical surgical treatment during the period of remission. However, scientists still have contradictions both about this definition and about the causes of pilonidal disease. Now there are two main theories of the etiology and pathogenesis of pilonidal disease: theories of congenital origin (empirical theories, the theory of neurogenic origin, theories of ectodermal origin) and acquired genesis. The most «popular» and reasoned in recent years is the theory of acquired genesis. So, the acquired mechanism of occurrence is confirmed in the experiment. He proves the possibility of penetration into the cavity of the pilonidal cyst hair rods (fragments) from various parts of the body, dirt, desquamated epithelium, particles of foreign bodies, etc. However, in children with a histological examination of the removed macropreparation (after radical removal of the pilonidal cyst), elements were found in the thickness of the walls that prove the congenital cause of the occurrence of pilonidal disease.
As a vivid illustration of the versatility of the factors of the formation and course of pilonidal disease in children, we present a clinical example from our own practice. He argues the introduction of etiopathogenetically substantiated methods of surgical treatment of pathology. These methods are based on the principles of eliminating congenital (constitutional) factors that contribute to the formation of the disease: economical excision of soft tissues in the area of the interalogodic folds, leveling its depth and lateralization of the suture line.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies.
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