Presacral Meningocele: Diagnosis and Treatment

Shédid, Daniel; Roger, Eric P.; Benzel, Edward C.

doi:10.1053/j.semss.2006.06.002

Cited by 18 publications

(37 citation statements)

References 34 publications

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“…Meningocele development is explained by CSF pulsation eroding the weakened sacral wall and leading to out-pouching. 18,22 ASM formation has also been described in the context of minor trauma to the anterior sacrum, through the same proposed mechanism of CSF pulsation and subsequent erosion. 9 Otherwise, some clinical conditions such as Currarino's triad and Marfan's have been associated with ASMs.…”

Section: Discussionmentioning

confidence: 99%

“…In the present report, our patient did not have any of these associated conditions. 10,22 The presentation of ASMs is highly variable; it is believed that the true incidence is underestimated due to their relatively asymptomatic nature. Approximately 300 cases of ASM have been described in the literature.…”

Section: Discussionmentioning

confidence: 99%

“…However, spontaneous regression of ASMs has not been observed and lifethreatening complications such as fistulization, meningitis, and rupture have been described. 5,6,21,22 Conversely, a surgical approach is indicated in the case of symptomatic compression of pelvic structures or fistulization. In the present case, obstructive renal failure and hydronephrosis were related to the mass effect of the ASM, and it was felt that the obstructive renal failure would continue to evolve without surgical intervention.…”

Section: Discussionmentioning

confidence: 99%

“…2, 22 The posterior sagittal approach has been used frequently in the treatment of pediatric colorectal disorders, and it allows good exposure to the pelvic floor while minimizing potential neurological complications. 18 The inferior presacral approach has a high risk of visceral injury and offers poor visualization of neural structures.…”

Section: Discussionmentioning

confidence: 99%

“…This involved direct visualization of the anomaly, aspiration of the meningocele contents, spinal cord detethering, meningocele pedicle ligation, and watertight closure. 22 Repair of the meningocele was first attempted through a sacral laminectomy. Operative findings revealed that the spinal cord was tethered anteriorly at the sacrum with nerve tissue extending into the abdominal portion of the meningocele (confirmed by intraoperative stimulation).…”

Section: Operationmentioning

confidence: 99%

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Successful management of a giant anterior sacral meningocele with an endoscopic cutting stapler: case report

Sunna

Westwick

Zaïri

et al. 2016

SPI

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Anterior sacral meningoceles (ASMs) are rare defects in the sacrum with thecal sac herniations and symptoms that commonly include constipation, dysmenorrhea, and urinary disturbances. An ASM causing hydronephrosis and acute renal failure from compression of the lower portion of the urinary tract is a rare clinical entity. Only one other case has been reported. The authors present the case of a 37-year-old man admitted for obstructive renal failure and hydronephrosis due to a giant ASM that measured 25 × 12 × 18 cm and compressed the ureters and bladder. The ASM was successfully treated via an anterior transabdominal approach in which the authors used a novel technique for watertight closure of the meningocele pedicle with an endoscopic cutting stapler. The authors review the literature and discuss the surgical options for the treatment of ASMs, specifically the management of ASMs in the context of obstructive renal failure and hydronephrosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Operationmentioning

confidence: 99%

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