Vol 2, No 1 (2026): Current Issue (Volume 2, Issue 1, 2026)

Introduction: Pilonidal sinus disease is increasingly recognized in the pediatric population, yet evidence on its clinical characteristics and surgical outcomes in children and adolescents remains limited. Given this gap, this study aimed to characterize the clinical presentation and surgical outcomes of natal cleft pilonidal sinus in a large pediatric cohort.

Methods: This retrospective cohort study included patients aged ≤18 years diagnosed with natal cleft pilonidal sinus over a five-year period. Clinical and sociodemographic data were extracted from medical records. All patients underwent minimal excision under local anesthesia with healing by secondary intention.

Results: A total of 1,751 patients were included, with a median age of 17 years and a near-equal sex distribution. Family history was positive in 65.8% of cases. Abscess formation was inversely associated with time to presentation (p < 0.001), while granuloma presence was associated with longer disease duration (p < 0.001). Females demonstrated higher abscess rates than males (30.2% vs 20.9%; p < 0.001). A positive family history was associated with earlier presentation (p = 0.007). Healing was achieved in 95.1% of cases, with a recurrence rate of 20.0% at a median follow-up of 36 months.

Conclusion: In pediatric pilonidal sinus disease, abscess and granuloma formation were associated with symptom duration, higher abscess rates in females, and earlier presentation with positive family history. Minimal excision under local anesthesia with outpatient secondary-intention healing warrants prospective comparative evaluation.