2018 Volume 54 Issue 2 Pages 290-294
We report a surgical case of a 5-month-old female infant with a fistula of the left lumbar region. The fistula with hair was detected at 2 months of age. It became red at 3 months of age, but treatment with an antibacterial agent did not improve it, and she was referred to our hospital. We found the fistula at the center of a subcutaneous abscess with 1 cm diameter. Ultrasonography showed that the fistula was 15 mm in length and ran to her back side and came to a blind end above the thoracolumbar fascia at the level of the bottom of her left kidney. After resolving the inflammation, magnetic resonance imaging revealed that the 17-mm-long blind fistula was completely within the subcutaneous tissue, and had no connection to the spinal canal. She underwent surgery to remove the fistula at 5 months of age to prevent recurrent infections. The fistula was completely resected at the level of the subcutaneous tissue. Histopathological findings showed that the wall was covered with a stratified squamous epithelium and had hair follicles inside. In general, congenital dermal sinuses are small tracts or dimples that open in the midline of the posterior of the body from the occiput to the lumbosacral region. Although the opening of the lesion was in the lateroabdominal area, that is, nonmiddle, the fistula was diagnosed as a congenital dermal sinus on the basis of her age at disease onset.
