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Thoracolumbar scoliosis posterior approach.

Obeid I, Bourghli A, Vital JM - Eur Spine J (2012)

View Article: PubMed Central - PubMed

Affiliation: Bordeaux University Hospital, 33076, Bordeaux, France. Ibrahim.obeid@chu-bordeaux.fr

ABSTRACT

Purpose: To report on a female patient diagnosed with Currarino’s triad in adulthood.

Case report: This case presents an adult patient with a medical history of a congenital anal atresia, a partial sacral agenesis, and a surgically treated ectopic anus. After a coincidentally observed presacral mass by MRI, due to unexplained constipation later in adulthood, Currarino’s triad was suspected in this patient. This triad consists of anorectal malformation(s), sacrococcygeal defects and a presacral mass of various origin. Further investigation confirmed the mass to be a meningocele, and showed a tethered cord and a syrinx.

Conclusions: In (young) patients with anorectal malformations, although having no other symptoms, further examination might be required to exclude Currarino’s triad. Importance of early diagnosis and multidisciplinary assessment is recommended to establish adequate treatment if needed.

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Related in: MedlinePlus

MRI with contrast enhancement. Arrow A: mild syringomyelia. Arrow B: tethered cord with medullary conus at L3–4 level. Arrow C: anterior meningocele
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Fig2: MRI with contrast enhancement. Arrow A: mild syringomyelia. Arrow B: tethered cord with medullary conus at L3–4 level. Arrow C: anterior meningocele

Mentions: During the second part of 2010, she experienced transient defecation difficulties. For that reason, the pediatric surgical team performed an MRI without contrast of the pelvic region. This showed the formerly known changes as expected from the ASARP procedure and the partial sacral agenesis. Coincidentally an anterior presacral mass of unknown origin, suggestive of a meningocele, as well as a bicornuate uterus was diagnosed (Fig. 2). Neurological examination did not reveal any deficits, explicitly there were neither pyramidal tract nor posterior column signs. The history of anorectal malformations, partial sacral agenesis and the presacral meningocele should prompt to the diagnosis of Currarino’s triad. This syndrome can be accompanied by a tethered cord, and a presacral mass of another origin, such as a teratoma. Therefore, we decided to perform a contrast-enhanced MRI of the lumbosacral spine, to rule out any of the above. It confirmed the presacral mass to be a meningocele. Furthermore, a moderate tethered cord was observed with the medullary conus at level L3–4, as well as a small syrinx. The radiologic findings and the absence of symptoms showed no need for surgical intervention. We decided to pursue a conservative approach and follow her in the outpatient clinic. If complaints or neurological symptoms should occur, depending on the incident pathology, transdural ligation of the meningocele or untethering of the spinal cord could be considered. Genetic counseling was initiated.Fig. 2


Thoracolumbar scoliosis posterior approach.

Obeid I, Bourghli A, Vital JM - Eur Spine J (2012)

MRI with contrast enhancement. Arrow A: mild syringomyelia. Arrow B: tethered cord with medullary conus at L3–4 level. Arrow C: anterior meningocele
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3369045&req=5

Fig2: MRI with contrast enhancement. Arrow A: mild syringomyelia. Arrow B: tethered cord with medullary conus at L3–4 level. Arrow C: anterior meningocele
Mentions: During the second part of 2010, she experienced transient defecation difficulties. For that reason, the pediatric surgical team performed an MRI without contrast of the pelvic region. This showed the formerly known changes as expected from the ASARP procedure and the partial sacral agenesis. Coincidentally an anterior presacral mass of unknown origin, suggestive of a meningocele, as well as a bicornuate uterus was diagnosed (Fig. 2). Neurological examination did not reveal any deficits, explicitly there were neither pyramidal tract nor posterior column signs. The history of anorectal malformations, partial sacral agenesis and the presacral meningocele should prompt to the diagnosis of Currarino’s triad. This syndrome can be accompanied by a tethered cord, and a presacral mass of another origin, such as a teratoma. Therefore, we decided to perform a contrast-enhanced MRI of the lumbosacral spine, to rule out any of the above. It confirmed the presacral mass to be a meningocele. Furthermore, a moderate tethered cord was observed with the medullary conus at level L3–4, as well as a small syrinx. The radiologic findings and the absence of symptoms showed no need for surgical intervention. We decided to pursue a conservative approach and follow her in the outpatient clinic. If complaints or neurological symptoms should occur, depending on the incident pathology, transdural ligation of the meningocele or untethering of the spinal cord could be considered. Genetic counseling was initiated.Fig. 2

View Article: PubMed Central - PubMed

Affiliation: Bordeaux University Hospital, 33076, Bordeaux, France. Ibrahim.obeid@chu-bordeaux.fr

ABSTRACT

Purpose: To report on a female patient diagnosed with Currarino’s triad in adulthood.

Case report: This case presents an adult patient with a medical history of a congenital anal atresia, a partial sacral agenesis, and a surgically treated ectopic anus. After a coincidentally observed presacral mass by MRI, due to unexplained constipation later in adulthood, Currarino’s triad was suspected in this patient. This triad consists of anorectal malformation(s), sacrococcygeal defects and a presacral mass of various origin. Further investigation confirmed the mass to be a meningocele, and showed a tethered cord and a syrinx.

Conclusions: In (young) patients with anorectal malformations, although having no other symptoms, further examination might be required to exclude Currarino’s triad. Importance of early diagnosis and multidisciplinary assessment is recommended to establish adequate treatment if needed.

Show MeSH
Related in: MedlinePlus