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Pilonidal Abscess: Hair today, gone tomorrow

August 16, 2014

This may seem like overkill; POCUS for an obvious abscess.

Still it was interesting to see the ingrown hair inside the abcess. Also the point of maximal induration was not where the actual abcess was, strangely enough.

So in the end the POCUS showed not only that the abscess was ready to be drained but where to I&D.

Pilonidal

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  1. Dean Smith says:

    Not overkill at all, and for the reason noted. Recently I had a similar experience of a “recurrent” pilonidal I&D’d by a colleague a couple days prior. POCUS revealed an abscess that spanned from a large/deep lesion on one side, across the midline to a smaller more superficial abscess (the point of previous I&D). With POCUS I could easily identify where to incise and the entirety of the abscess was drained. While not routine, I’m pretty quick to grab the probe if there is any suspicion of a more complex or deep lesion.