Umbilical pilonidal sinus- an unusual presentation

Umbilical Pilonidal Sinus (UPS) is a very rare form of umbilical disease. The presenting feature is usually pain and umbilical discharge. It affects active adolescent males with hairy abdomen and a deep naval. Treatment depends on the type of presentation with no consensus guidelines for the management of this disease. Most of the cases are managed conservatively with extraction of the hair and maintenance of personal hygiene. Surgery is indicated on failure of conservative management. Although umbilectomy is usually performed; complete sinus excision with reconstruction is done for cosmetic reasons. The commonest cause of failure of conservative management is incomplete hair extraction from the sinus tract. We present herewith a case of 27-year-old male, with umbilical pain, swelling, purulent discharge and bleeding on and off for the last 4 years. After repeated failed conservative management patient underwent excision of the sinus tract. After 2 years of follow up, the patient has no residual disease and has no complaints. This case emphasises the need for proper clinical examination for early detection of disease.