Contradictory views on the acquired and congenital etiology of pilonidal disease

Abstract

Pilonidal disease is a pathology that was first described more than 100 years ago. However, it still remains the subject of discussion, because there is still no clear unambiguous definition of this pathology, nor its well-known etiology. Despite the large number of developed and substantiated theories, there are still two opposing views on the cause of pilonidal disease. Some scientists are supporters of the “congenital” theory, others – the theory of acquired origin. However, this does not clarify the ultimate goal of these studies: to develop optimal treatment tactics. The purpose of the work is to clarify the data on the etiology of pilonidal disease in children. The study is based on the results of treatment analysis of 37 children diagnosed with “pilonidal disease” who were hospitalized in the Department of Emergency Surgery of Vinnytsia Regional Children’s Clinical Hospital, of which boys – 26, girls – 11. The mean age of patients was 16.4±0.4 years. Histological sections of tissue samples were stained with hematoxylin and eosin. Microscopy and creation of a photo archive of histological specimens were performed using a light microscope OLIMPUS BX 41 at a magnification of 100 and 200, in the software environment “Quick PHOTO MICRO 2.3”. The study found that there are significant differences in the histological structure of pilonidal cysts in children and adults. In pediatric patients, mesenchymal tissue was found, which is not typical for this group of patients. It was also found that the cavity of the pilonidal cyst in children is covered with a multilayered squamous non-keratinizing epithelium, and there is almost no granulation tissue. In our opinion, pilonidal disease is a polyetiological disease, the main cause of which is the congenital features of the organism, which are realized due to socio-economic and environmental factors.