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[Anterior sacral meningocele. Case report].
Neurologia Medico-Chirurgica
|August 1, 1989
Summary
An anterior sacral meningocele, a rare spinal defect, can present as an abdominal mass. Surgical repair is complex but can lead to good outcomes, though complications like subdural hematomas may occur.
Area of Science:
- Neurology
- Radiology
- Surgical Oncology
Background:
- Anterior sacral meningocele is a rare congenital condition characterized by a dural sac protrusion through a sacral defect.
- It can present with diverse symptoms, including abdominal mass and urinary disturbances, often mimicking other pathologies.
Observation:
- A 53-year-old male presented with an abdominal mass and urinary issues, exhibiting a scimitar deformity of the sacrum on X-ray.
- CT and myelography revealed a large pelvic cyst with a bony defect at S2, confirming anterior sacral meningocele.
- MRI delineated the abdominal mass and its connection to the thecal sac via the anterior sacral defect.
Findings:
- Surgical resection via a transabdominal approach was challenging due to intestinal adhesions.
- A meningocele-peritoneal shunting procedure and partial resection were performed.
- Postoperatively, the patient developed bilateral chronic subdural hematomas, successfully treated with surgical evacuation.
Implications:
- This case highlights the complex presentation and surgical management of anterior sacral meningoceles.
- Early diagnosis through advanced imaging is crucial for appropriate intervention.
- Potential postoperative complications, such as subdural hematomas, necessitate vigilant monitoring and timely management.