Answer for BIR CoW 17 Apr 2022
PARTIAL SACRAL AGENESIS WITH ANTERIOR SACRAL MENINGOCELE
Findings
T2 HYPERINTENSE LESION IN THE PRESACRAL REGION IN COMMUNICATION WITH THE THECAL SAC THROUGH THE TIP OF SACRUM WITH ABSENT S2-S5 AND COCCYX. SCIMITAR SACRUM ON XRAY LS SPINE
Discussion
Anterior sacral meningocele is a congenital anomaly characterized by agenesis of a part of the anterior portion of the sacrum, herniation of meninges through the defect, and formation of a hernial sac in the pelvis. There is no external manifestation of the anomaly and the diagnosis is made on the basis of clinical suspicion and x-ray confirmation. Symptoms, if any, are usually secondary to the pressure of the meningocele on the rectum and indirectly on the urinary bladder and other pelvic organs; constipation, frequency, urgency, and dysuria are the most common complaints. Dysmenorrhea and dyspareunia with headache may be present in women. Headache may also occur during and following bowel evacuation. Therapy depends on the seriousness of the symptomatology. The only effective treatment is surgical amputation of the hernial sac. This, however, is a major procedure and is not indicated unless the symptoms are so severe as seriously to incapacitate the patient.
REFERENCES:
1. Krivokapić Z, Grubor N, Micev M et-al. Anterior sacral meningocele with presacral cysts: report of a case. Dis. Colon Rectum. 2004;47 (11): 1965-9.
2. Dahan H, Arrivé L, Wendum D et-al. Retrorectal developmental cysts in adults: clinical and radiologic-histopathologic review, differential diagnosis, and treatment. Radiographics. 21 (3): 575-84.
3. Calihan RJ. Anterior sacral meningocele. Radiology. 1952;58 (1): 104-8.
Findings
T2 HYPERINTENSE LESION IN THE PRESACRAL REGION IN COMMUNICATION WITH THE THECAL SAC THROUGH THE TIP OF SACRUM WITH ABSENT S2-S5 AND COCCYX. SCIMITAR SACRUM ON XRAY LS SPINE
Discussion
Anterior sacral meningocele is a congenital anomaly characterized by agenesis of a part of the anterior portion of the sacrum, herniation of meninges through the defect, and formation of a hernial sac in the pelvis. There is no external manifestation of the anomaly and the diagnosis is made on the basis of clinical suspicion and x-ray confirmation. Symptoms, if any, are usually secondary to the pressure of the meningocele on the rectum and indirectly on the urinary bladder and other pelvic organs; constipation, frequency, urgency, and dysuria are the most common complaints. Dysmenorrhea and dyspareunia with headache may be present in women. Headache may also occur during and following bowel evacuation. Therapy depends on the seriousness of the symptomatology. The only effective treatment is surgical amputation of the hernial sac. This, however, is a major procedure and is not indicated unless the symptoms are so severe as seriously to incapacitate the patient.
REFERENCES:
1. Krivokapić Z, Grubor N, Micev M et-al. Anterior sacral meningocele with presacral cysts: report of a case. Dis. Colon Rectum. 2004;47 (11): 1965-9.
2. Dahan H, Arrivé L, Wendum D et-al. Retrorectal developmental cysts in adults: clinical and radiologic-histopathologic review, differential diagnosis, and treatment. Radiographics. 21 (3): 575-84.
3. Calihan RJ. Anterior sacral meningocele. Radiology. 1952;58 (1): 104-8.
Note:
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!