Karydakis flap procedure in patients with sacrococcygeal pilonidal sinus disease: experience of a single centre in Istanbul.

BACKGROUND: The aim of this retrospective study was to evaluate the results of patients with sacrococcygeal pilonidal sinus who underwent surgery using the Karydakis technique. METHODS: Two hundred fifty-seven patients with sacrococcygeal pilonidal sinus disease were treated by the Karydakis flap procedure between December 2003 and June 2011. Patients were evaluated with respect to age, gender, preoperative symptoms, duration of preoperative symptoms, history of pilonidal sinus surgery, early postoperative complications, recurrence rates, and cosmetic satisfaction. RESULTS: There were 223 (86.8%) male and 34 (13.2%) female patients. The mean age of the patients was 27.15 ± 7.69 years. The most frequent symptom was seropurulent discharge (57.58%). Postoperative morbidity was noted in 24 patients (9.3%). The mean hospital length of stay was 3.34 ± 1.42 days. The cosmetic satisfaction rate was 91.06%. Recurrences were noted in 6 patients (2.3%). CONCLUSION: The Karydakis flap procedure is a safe treatment alternative for the surgical treatment of sacrococcygeal pilonidal sinus disease owing to the associated low complication rate, short hospital length of stay, rapid healing, and a high patient satisfaction rate.

[A case of Rapunzel syndrome]. / Rapunzel sendromu: Olgu sunumu.

Trichobezoars are concretions of hair casts in the stomach associated with trichotillomania and trichophagia. The condition is termed Rapunzel syndrome when formation of a huge trichobezoar extends to the small bowel, resulting in gastrointestinal obstruction. We present a 19-year-old girl who had complaints of colicky abdominal pain, nausea and vomiting seven years after surgical treatment for a gastric trichobezoar. Gastric endoscopy was performed with an initial diagnosis of recurrent trichobezoar, which revealed a huge one. The patient underwent laparotomy, during which a huge trichobezoar with a long tail was totally removed by an anterior gastrotomy. Following removal of the lesion, the antrum was observed with multiple ulcers secondary to extensive pressure. Postoperative period was uneventful. A subsequent psychiatric consultation revealed depressive personality disorder.