The key difference between fistula and pilonidal sinus is that fistula is a disease due to the formation of a passageway inside an infected gland of the anus while pilonidal sinus is a disease due to the formation of a small tunnel at the top of the crease between the buttocks.
Fistula and pilonidal sinus are two medical diseases associated with abscesses in different regions of the body. In very rare cases, pilonidal sinus can cause fistula, as well. When a pilonidal sinus progresses to the development of a fistula, it is referred to as pilonidal fistula-in-ano. Moreover, both diseases may have similar symptoms. But these diseases have very different aetiologies and management.
CONTENTS
1. Overview and Key Difference
2. What is Fistula
3. What is the Pilonidal Sinus
4. Similarities – Fistula and Pilonidal Sinus
5. Fistula vs. Pilonidal Sinus in Tabular Form
6. FAQ – Fistula and Pilonidal Sinus
7. Summary – Fistula vs. Pilonidal Sinus
What is Fistula?
Fistula or anal fistula is an abnormal passageway that develops from inside the anus to the skin outside. It usually develops in the upper part of the anus, where the anal glands are located. This disease is more common in men and people assigned male at birth (AMAB). The symptoms of this disease may include anal pain, swelling and redness inside or around the anus, fever, pain in urine, and difficulty holding stool in. A fistula usually occurs when the tissues are inflamed for a long time due to an injury or disease. The possible complications from this disease are persistent infection, fistula extension, and cancer.
Figure 01: Fistula
Fistula can be diagnosed through physical examination, MRI, endoscopic ultrasound, and fistulography. Furthermore, the treatment options for fistula may include nonsurgical options such as seton placement, fibrin glue and collagen plug, medication (pain medications and Crohn’s disease), surgeries such as fistulotomy, endorectal advancement flap, and ligation of the intersphincteric fistula tract (LIFT).
What is the Pilonidal Sinus?
A pilonidal sinus is a small hole or tunnel in the skin that occurs in the cleft at the top of the buttocks. The pilonidal sinus may fill with fluid or pus. The exact cause of this disease isn’t known; however, it is believed to be caused by a combination of changing hormones, hair growth, and friction from clothes or from spending a long time sitting. Moreover, the symptoms of this disease may include a pit near the top of the buttocks crease, pain, inflammation, swollen skin, pus or blood leaking from an opening in the skin, and an odour from draining pus. The complications resulting from this disease are recurrence and wound healing issues such as wound breakdown or surgical site infection.
Pilonidal sinus can be diagnosed through physical examination, CT scan, and MRI. Furthermore, treatment options for pilonidal sinus may include medicines such as antibiotics and pain medications such as paracetamol, lancing, phenol injection, and surgery.
What are the Similarities Between Fistula and Pilonidal Sinus?
- Fistula and pilonidal sinus are two medical diseases that are associated with abscesses in different regions of the body.
- Both diseases may have similar symptoms as well.
- They can cause complications.
- Both diseases can be diagnosed through physical examination and imaging testing.
- They can be treated through specific medications and surgeries.
What is the Difference Between Fistula and Pilonidal Sinus?
Fistula is a disease due to the formation of a passageway inside an infected gland of the anus while pilonidal sinus is a disease due to the formation of a small tunnel at the top of the crease between the buttocks. Thus, this is the key difference between fistula and pilonidal sinus. Furthermore, the possible complications from fistula are persistent infection, fistula extension, and cancer, while the possible complications from pilonidal sinus are recurrence and wound healing issues such as wound breakdown or surgical site infection.
The infographic below presents the differences between fistula and pilonidal sinus in tabular form for side-by-side comparison.
FAQ: Fistula and Pilonidal Sinus
Why is it called pilonidal?
“Pilonidal” comes from the Latin words “pilus” (hair) and “nidus” (nest), reflecting the condition’s association with hair follicles and the formation of cysts or sinuses.
Is pilonidal sinus a fistula?
Yes, When a pilonidal sinus establishes a connection with another organ or vessel, it is referred to as pilonidal fistula-in-ano.
How can you tell the difference between an abscess and a fistula?
An abscess is a painful, swollen lump filled with pus, while a fistula is an abnormal tunnel-like connection between two body parts or a body part and the skin surface.
Summary – Fistula vs. Pilonidal Sinus
Fistula and pilonidal sinus are diseases that occur due to abscesses in different regions of the body. Both may show similar symptoms as well. However, fistula refers to the formation of a passageway inside an infected gland of the anus while pilonidal sinus refers to the formation of a small tunnel at the top of the crease between the buttocks. So, this summarizes the difference between fistula and pilonidal sinus.
Reference:
1. “Pilonidal sinus.” NHS Choices, NHS.
2. “Fistula – An Overview.” ScienceDirect Topics.
Image Courtesy:
1. “Fistula diag 01-it” By Jmarchn – Own work (CC BY-SA 3.0) via Commons Wikimedia