Successful management of a giant anterior sacral meningocele with an endoscopic cutting stapler: case report

Abstract

<jats:p>Anterior sacral meningoceles (ASMs) are rare defects in the sacrum with thecal sac herniations and symptoms that commonly include constipation, dysmenorrhea, and urinary disturbances. An ASM causing hydronephrosis and acute renal failure from compression of the lower portion of the urinary tract is a rare clinical entity. Only one other case has been reported. The authors present the case of a 37-year-old man admitted for obstructive renal failure and hydronephrosis due to a giant ASM that measured 25 × 12 × 18 cm and compressed the ureters and bladder. The ASM was successfully treated via an anterior transabdominal approach in which the authors used a novel technique for watertight closure of the meningocele pedicle with an endoscopic cutting stapler. The authors review the literature and discuss the surgical options for the treatment of ASMs, specifically the management of ASMs in the context of obstructive renal failure and hydronephrosis.</jats:p>

Thalidomide Embryopathy as Possible Cause of Anterior Sacral Meningocele: A Case Report

“…Considering the complexity of surgery to correct an ASM, its management should be based on the severity of patient's symptoms (Hanna and Morandi, ; Ashley and Wright, ; Sunna et al, ). Asymptomatic or mildly symptomatic patients may do better with a conservative approach and follow‐up as needed.…”

Primary Sacral Hydatid Cyst Mimicking a Neurogenic Tumor in Chronic Low Back Pain: Case Report and Review of the Literature

“…This lesion is seen with equal signal intensities of cerebrospinal fluid on all MR sequences and is usually unilocular. [28] Song et al mistook a SHC with a GCT on MR. [15] The most common GCTs site is distal femur and proximal tibia in 50%-65%, but can affect sacrum in 4%-9% of cases. [29] The MR T2-weighted images show a heterogeneous high signal with areas of low-signal intensity (variable) due to hemosiderin or fibrosis.…”

Association of syringomyelia with lower urinary tract dysfunction in anterior sacral meningocele with a tethered spinal cord: A case report and literature summary

“…We reviewed all six reported cases of ASM with TSC, all of whom underwent untethering surgery (Table ). In those cases, urinary symptoms were resolved in three patients after TSC release, whereas the other three cases remained symptomatic despite improved neurological function in the extremities . We investigated the MRI features that are associated with prognosis for LUT function and found that in all patients who remained symptomatic, MRI showed syringomyelia, which was not found in cases with symptom alleviation.…”

“…ASM is divided into two groups based on the presence or absence of TSC. Cases of ASM presenting with TSC are much rarer, and are typically identified by neurological symptoms and/or dysuria in patients with a wide age range . In such cases, untethering surgery is carried out in patients with neurological symptoms in the extremities.…”