Anterior sacral meningocele and constipation

Meningocele sacro anterior y estreñimiento

A case is presented of a 25 year-old woman with chronic constipation in whom the diagnosi was initially confused with a gynaecological disease or a tumour. The exploratory laparotomy showed evidence of a cystic lesion hanging from the anterior side of the sacrum. Diagnostic imaging with computed tomography was performed in which an anterior sacral meningocele was observed. Magnetic resonance was then used to rule out any other associated lesions. It was decided to treat it surgically with a posterior approach for resection and laminectomy of the meningocele, with a good post-surgical outcome. In the follow-up at 3 months the patient showed no neurological deficit, no loss of sensitivity in the perineal region, and no changes in her autonomic nervous system.

1. Ashley WW, Wright NM. Resection of a giant anterior sacral meningocele via an anterior approach: case report and review of literature. Surg Neurol. 2006;66:89–93.

2. Santana JM, Gómez A, Alemán P, Travieso MM. Uretero hidronefrosis severa asociada a meningocele sacro anterior gigante asintomático: presentación de un caso y revisión de la literatura. Radiología. 2007;49:43–6.

3. Fitzpatrick MO, Taylor WA. Anterior sacral meningocele associated with a rectal fistula. Case report and review of the literature. J Neurosurg. 1999;91 1 Suppl:124–7.

4. Diz-Lois MT, Souto J, Yáñez JA, Vázquez MA, San Millán AM, Vázquez JL. Masa submucosa rectal y meningitis aguda: presentación de un meningocele sacro anterior. Rev Esp Enferm Dig. 2005;97:756–7.

5. Lee KS, Gower DJ, McWhorter JM, Albertson DA. The role of MR imaging in the diagnosis and treatment of anterior sacral meningocele. Report of two cases. J Neurosurg. 1988;69:628–31.

6. Antuña-Ramos A, García-Fructuoso G, Alamar-Abril M, Guillén-Quesada A, Costa-Clara JM. Meningocele sacro anterior oculto. Neurocirugía. 2011;22:342–6.

7. Dyck P, Wilson CB. Anterior sacral meningocele. Case report. J Neurosurg. 1980;53:548–52.

8. Beyazal M. An asymptomatic large anterior sacral meningocele in a patient with a history of gestation: A case report with radiological findings. Case Rep Radiol. 2013;2013:842620.

9. Koksal A, Canyigit M, Kara T, Ulus A, Gokbayir H, Sarisahin M. Unusual presentation of an anterior sacral meningocele: Magnetic resonance imaging, multidetector computed tomography, and fistulography findings of bacterial meningitis secondary to a rectothecal fistula. Jpn J Radiol. 2011;29:528–31.

10. Polat AV, Belet U, Aydin R, Katranci S. Anterior sacral meningocele mimicking ovarian cyst: a case report. Med Ultrason. 2013;15:67–70.

11. Gardner PA, Albright AL. “Like mother, like son:” Hereditary anterior sacral meningocele. Case report and review of the literature. J Neurosurg. 2006;104 2 Suppl:138–42.