Diverticulitis complicated by fistulous communication of sigmoid colon with anterior sacral meningocele in a patient with Marfan syndrome

Abstract

Rare in the general public, dural ectasia is a common finding in patients with Marfan syndrome. Complications are not frequent but include constipation, urinary retention, and meningitis. Presented here is a case of bacterial meningitis secondary to fistulous communication between a sacral meningocele and sigmoid colon in the setting of diverticulitis.

Abdominal Symptoms and Colonic Diverticula in Marfan’s Syndrome: A Clinical and Ultrasonographic Case Control Study

“…However, whereas joint hypermobility syndrome and EDS display a high prevalence of functional GI disorders, in MFS, the prevalence of GI disorders is still disputed [ 13 , 14 , 24 , 25 ]. To date, GI disease associated with MFS has been reported only in case series, highlighting, in particular, its association with complications of intestinal diverticula, a condition for which MFS is historically considered a genetic risk factor [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 ]. Furthermore, the level of evidence supporting the relationship between MFS and diverticulosis, and its potentially related symptoms, is still unsatisfactory.…”

“…It is worth noting that, at present, the GI manifestations of MFS are poorly documented. Thus far, in the literature, there are only case series reporting the association between MFS, abdominal pain and altered evacuation, and, in particular, cases of severe acute diverticulitis or complications of diverticulosis, for which MFS is historically considered a risk factor [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 ]. Inayet et al [ 13 ] and Nee et al [ 14 ] recently evaluated the prevalence of functional GI diseases and pelvic floor symptoms in a cohort of MFS patients compared to patients with Ehlers–Danlos syndrome, a group of inherited heterogenous multisystem disorders often in differential diagnosis with MFS (as far as skin hyperextensibility, atrophic scarring, joint hypermobility, and generalized tissue fragility are concerned).…”