Severe constipation due to sacral perineural cysts in a pediatrics patient: A case report
Hiroya Shimauchi-Ohtaki1, Fumiaki Honda1, Shunsuke Nakamura1
1Department of Neurosurgery, Gunma University, Maebashi, Gunma, Japan.
Insights
Symptomatic perineural cysts are rare in children. Microsurgery for sacral perineural cysts causing severe bowel dysfunction in a pediatric patient showed no recurrence after five years, suggesting a positive long-term outcome.
Area of Science:
- Pediatric Neurology
- Neurosurgery
- Gastroenterology
Background:
- Symptomatic perineural cysts are uncommon in pediatric populations.
- Severe bowel dysfunction from sacral perineural cysts is exceptionally rare in children.
- The long-term efficacy of surgical interventions for pediatric perineural cysts remains largely unestablished.
Observation:
- A 13-year-old female presented with severe constipation, intractable vomiting, low back and buttock pain, urinary incontinence, and periproctal sensory disturbances.
- Radiological imaging identified bilateral perineural cysts originating from the S3 nerve roots as the likely etiology.
- The patient underwent successful microsurgical decompression of the cysts.
Findings:
- The microsurgical decompression effectively resolved the patient's intractable bowel dysfunction.
- No recurrence of the perineural cysts or associated symptoms was observed during a five-year follow-up period.
- This outcome indicates the potential for sustained relief following surgical intervention.
Implications:
- Microsurgery for symptomatic sacral perineural cysts may offer a favorable long-term prognosis in pediatric cases.
- This case highlights the importance of considering perineural cysts in the differential diagnosis of pediatric functional bowel disorders.
- Further research into surgical outcomes for pediatric perineural cysts is warranted to support clinical decision-making.
Background:
Symptomatic perineural cysts are rare in pediatric patients. Severe bowel dysfunction caused by the perineural cysts at the sacral level is particularly rare in children. Moreover, the long-term outcome of surgery for the perineural cysts in pediatric patients is uncertain. Here, we describe a rare case of perineural cysts originating in the S3 roots in a pediatric patient that manifested as severe constipation.
Case Description:
The case was a 13-year-old girl who presented with intractable vomiting and constipation. She also had low back and buttock pain, urinary incontinence, and periproctal sensory disturbance. Radiological studies revealed bilateral perineural cysts originating from the S3 nerve roots, which were considered to be the cause of her symptoms. Microsurgical decompression of the cysts relieved her intractable bowel dysfunction. There has been no recurrence in the 5 years since surgery.
Conclusion:
This case suggests that microsurgery for severe bowel dysfunction due to symptomatic perineural cysts could have a satisfactory long-term outcome in pediatric patients.
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