Lateral buttock and postanal congenital dermal sinus tract

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Abstract

We present 2 rare cases of lateral buttock and postanal congenital dermal sinus tract. These 2 children were noted to have a pit in the left upper lateral buttock and a postanal orifice after birth. Magnetic resonance imaging, computed tomography, and ultrasonography showed an inflammatory mass lesion in the buttock and a funicular structure adjacent to the rectum. Fistulography showed no connection between the pit and orifice. Surgical exploration revealed firm tracts from both the lateral buttock and postanus running deep to the tip of the coccyx. Histopathologic findings showed squamous cells in the walls of the sinus tracts. Our report broadens the clinical literature regarding congenital dermal sinus tract. We postulate that this disease may not always have a connection with the central nervous system, and our cases may provide examples of anal fistulas of congenital etiology in infants.

Section snippets

Case reports

A 3-year-old girl and a 5-year-old boy presented with a long history of recurrent infection on their left buttock. Both families stated that a pit on the buttock and a postanal orifice had been visible since birth. The general health of the patients was excellent, and there was no significant medical history except for the recurrent infection of the buttock. The boy had undergone pit excision at the age of 3. He was admitted to an outside hospital for the management of his recurrent infections,

Discussion

Congenital dermal sinus tracts are epithelium-lined tracts that run from the skin to deeper tissues at various lengths. This disease most commonly involves the midline, and when it occurs in this location, if the lesion penetrates the spinal canal, or ends blindly in the subcutaneous tissue, it is termed a congenital spinal dermal sinus [4]. This disease has also been reported to occur in other locations such as the peristernal region [6], the frontotemporal region [2], and the periauricular

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1

These authors contributed equally to this study.

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