We report a 27-year-old female who presented with abdominal distension, saddle anesthesia, and lower back pain. CT and MRI of the abdomen/spine were performed which showed a large anterior sacral meningocele occupying...We report a 27-year-old female who presented with abdominal distension, saddle anesthesia, and lower back pain. CT and MRI of the abdomen/spine were performed which showed a large anterior sacral meningocele occupying most of the pelvic and abdominal cavity and displacement of their respective contents. Anterior approach was chosen, uterine didelphys was identified and mobilized, meningocele identified and gentle drainage with subsequent resection of the cyst wall and watertight closure was achieved. Subsequent MRI demonstrated resolution of most the sacral meningocele. Patient symptoms improved and are doing well.展开更多
We report a 24-year-old male who presented with abdominal distension, constipation and left sided groin pain. CT and MRI of the abdomen/spine were performed which showed a large anterior sacral meningocele occupying m...We report a 24-year-old male who presented with abdominal distension, constipation and left sided groin pain. CT and MRI of the abdomen/spine were performed which showed a large anterior sacral meningocele occupying most of the pelvic and abdominal cavity and displacement of their respective contents. Initially a posterior approach with lumbosacral laminectomy (L5 - S4) was performed. The ostium of the meningocele was identified with several nerve roots identified passing through, adjacent and into the defect. As nerve roots traversed the ostium, watertight closure was not feasible without sacrificing nerve roots. Subsequent MRI demonstrated recurrence of approximately 60% of the anterior sacral meningocele. We therefore opted to approach the ASM anteriorly via an anterior approach with the help of colorectal surgical colleague. The ASM was completely embedded within the sigmoid and upper to mid rectal mesentry, with its own vascular supply to the thick walled capsule. This case highlights the need for a combined approach due to the incorporation of the pseudomeningocele into the omentum with the development of its own blood supply.展开更多
文摘We report a 27-year-old female who presented with abdominal distension, saddle anesthesia, and lower back pain. CT and MRI of the abdomen/spine were performed which showed a large anterior sacral meningocele occupying most of the pelvic and abdominal cavity and displacement of their respective contents. Anterior approach was chosen, uterine didelphys was identified and mobilized, meningocele identified and gentle drainage with subsequent resection of the cyst wall and watertight closure was achieved. Subsequent MRI demonstrated resolution of most the sacral meningocele. Patient symptoms improved and are doing well.
文摘We report a 24-year-old male who presented with abdominal distension, constipation and left sided groin pain. CT and MRI of the abdomen/spine were performed which showed a large anterior sacral meningocele occupying most of the pelvic and abdominal cavity and displacement of their respective contents. Initially a posterior approach with lumbosacral laminectomy (L5 - S4) was performed. The ostium of the meningocele was identified with several nerve roots identified passing through, adjacent and into the defect. As nerve roots traversed the ostium, watertight closure was not feasible without sacrificing nerve roots. Subsequent MRI demonstrated recurrence of approximately 60% of the anterior sacral meningocele. We therefore opted to approach the ASM anteriorly via an anterior approach with the help of colorectal surgical colleague. The ASM was completely embedded within the sigmoid and upper to mid rectal mesentry, with its own vascular supply to the thick walled capsule. This case highlights the need for a combined approach due to the incorporation of the pseudomeningocele into the omentum with the development of its own blood supply.
