UPSC aspirant treated for pilonidal sinus, condition first identified during World War 2. What is it?

This ailment, known colloquially as 'Jeepers Bottom,' was first described during World War II in soldiers.

A 21-year-old UPSC aspirant has undergone successful treatment for pilonidal sinus, a condition characterised by painful pus formation near the tailbone. This ailment, known colloquially as "Jeepers Bottom," was first described during World War II in soldiers, according to a statement from Sir Ganga Ram Hospital.

The student, who had been preparing for his exams while spending extended hours seated at library chairs, began experiencing severe discomfort and swelling in the area between his buttocks. The condition deteriorated with increasing pus discharge and significant pain, eventually confining him to bed, PTI reported.

Dr Tarun Mittal from the Department of Laparoscopic and Laser Surgery at Sir Ganga Ram Hospital explained, “Considering the patient's condition, we opted for EPSiT (Endoscopic Pilonidal Sinus Tract Ablation Surgery) as the most effective approach to enable a swift recovery.”

This technique, which involves the use of an endoscope, allowed for a thorough examination and removal of hair and debris from the sinus tract. The procedure, which took approximately 30 minutes, included the introduction of an endoscope to visualise and remove the hair with forceps, followed by cauterisation to eliminate remaining debris and curettage with a brush.

Dr Mittal noted that the minimally invasive nature of the EPSiT technique facilitates rapid recovery, enabling patients to resume normal activities almost immediately after the operation.

What is pilonidal sinus?

Pilonidal sinus is a condition characterized by a small, abnormal pocket or cavity located near the tailbone (coccyx) at the top of the buttocks.

Causes and Risk Factors: Pilonidal sinus often develops due to hair and debris becoming trapped in the cavity under the skin. This can lead to irritation, infection, and inflammation. Risk factors include prolonged sitting, such as in long periods of driving or sitting at a desk, as well as having thick or coarse hair. It is more common in young adults and can be influenced by factors like obesity and a sedentary lifestyle.

Symptoms: Symptoms of pilonidal sinus may include pain, swelling, and tenderness near the tailbone. The area may produce pus or blood, and the sinus can become infected, leading to abscess formation. In some cases, individuals may experience a noticeable lump or a discharge from the area.

Diagnosis: Diagnosis is usually based on a physical examination. In some cases, imaging tests such as ultrasound or MRI may be used to assess the extent of the sinus tract and identify any associated abscesses.

Treatment: Treatment options vary depending on the severity of the condition. Initial management may involve antibiotics and drainage of any abscesses. For persistent or recurrent cases, surgical intervention may be necessary. Surgical options include excision of the sinus tract and the surrounding tissue or endoscopic procedures like EPSiT (Endoscopic Pilonidal Sinus Tract Ablation Surgery), which aims to remove hair and debris while minimising recovery time.

Prevention: Preventive measures include maintaining good hygiene, avoiding prolonged sitting, and managing risk factors like excessive hair growth and obesity. Regular monitoring and early treatment can help prevent complications and recurrence.