A Rare Case of Anterior Sacral Meningocele (ASM) in a Young Patient

作     者：Shanu Gambhir Mark Winder Gareth Owen Shanu Gambhir;Mark Winder;Gareth Owen

作者机构：Department of Neurosurgery St. Vincent’s Hospital Darlinghurst Australia 

出 版 物：《Open Journal of Modern Neurosurgery》 (现代神经外科学进展（英文）)

年 卷 期：2016年第6卷第1期

页      面：16-19页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Spina Bifida Sacral Meningocele Abdominal Distension 

摘      要：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.