Gluteal protuberance as a first symptom of branched pilonidal sinus with anal fistula – case report

Abstract

The authors present the case of a patient who underwent a surgery due to a branched pilonidal sinus with branching to anal sphincters and a purulent cistern in the left buttock. The lesion was diagnosed accidentally. The patient’s main ailments were non-specific buttock pains experienced for several months, which were followed by periodic febrile states. Advanced diagnostics of this region was planned and carried out. The patient was qualified for Bascom II procedure with simultaneous excision of the anal fistula tract and opening of the left buttock fluid cistern. No complications were observed in the postoperative course. The follow-up after 2 months showed no recurrence. The authors emphasize the fact that the lesions of the gluteal cleft are difficult to diagnose, diagnosed late and often asymptomatic. Proper diagnostics and proper surgical technique allow for complete cure.