[Presacral tumor with sacral meningocele]

Area of Science:

• Pediatric Surgery
• Colorectal Surgery
• Congenital Malformations

Background:

• Anorectal malformations, such as rectal atresia, often require surgical correction in infancy.
• Persistent fecal incontinence can occur even after initial surgical procedures like the Rehbein procedure.
• Currarino triad is a rare condition involving anorectal malformation, anterior sacral meningocele, and a presacral tumor.

Observation:

• A 10-year-old male presented with persistent fecal incontinence post-Rehbein procedure for rectal atresia.
• Preoperative evaluation revealed the presence of Currarino triad: anorectal malformation, anterior sacral meningocele, and a solid presacral tumor.
• The patient had previously undergone the Rehbein procedure in infancy.

Findings:

• Two initial surgical interventions were performed to successfully resect the presacral tumor and the anterior sacral meningocele.
• A subsequent gracilis plastic operation, performed three months later, successfully addressed the remaining fecal incontinence.
• The combined surgical approach managed the complex congenital anomalies and functional deficits.

Implications:

• This case highlights the importance of comprehensive preoperative assessment for complex anorectal malformations.
• Gracilis plastic surgery can be an effective treatment for fecal incontinence secondary to complex congenital anomalies.
• Multistage surgical management is crucial for addressing the spectrum of issues in Currarino triad, improving patient outcomes.