Currarino Triad: Importance of Preoperative Magnetic Resonance Imaging

IF 0.6 Q4 SURGERY
A. AbouZeid, S. Mohammad, M. Seada, Khaled Khiamy, R. Gamal
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引用次数: 4

Abstract

Abstract Currarino triad is a rare syndrome that may be occasionally encountered during managing cases of anorectal anomalies. The triad consists of anorectal anomaly, sacral bony defect, and a presacral mass. It may be familial or sporadic, with a reported female predominance. Identification of the characteristic notched sacrum (sacral scimitar) in plain X-ray (anteroposterior view) is considered the key for the diagnosis; however, not infrequently, this radiological sign is overlooked, especially with a small sacral defect. Excision of the presacral cyst is usually performed concomitantly during anorectoplasty. The prone position is the standard approach for posterior sagittal anorectoplasty (PSARP) in males; however, in females, the supine position can be used as an alternative (anterior sagittal anorectoplasty). In this case report, excision of the presacral cyst took place in two steps: the first excision during the PSARP procedure in the prone position, and a second operation in the supine lithotomy position to remove a residual component of the lesion that was missed during the primary operation. It was clear that the supine lithotomy position provided better access to explore the presacral space than the prone position, especially with a deeply located cyst as in our case. The role of magnetic resonance imaging (MRI) in the identification of the exact nature and extent of the lesion before surgery is crucial and should be performed in all cases.
Currarino Triad:术前磁共振成像的重要性
摘要Currarino三联征是一种罕见的综合征,在处理肛门直肠异常病例时偶尔会遇到。三联征包括肛门直肠异常、骶骨缺损和骶前肿块。它可能是家族性的或散发性的,据报道以女性为主。在平片(前后视图)中识别特征性的骶骨切口(骶骨弯刀)被认为是诊断的关键;然而,这种放射学征象经常被忽视,尤其是在骶骨小缺损的情况下。骶前囊肿切除术通常在肛门直肠成形术的同时进行。俯卧位是男性后矢状面肛门直肠成形术(PSARP)的标准方法;然而,对于女性来说,仰卧位可以作为一种替代方案(前矢状面肛门直肠成形术)。在本病例报告中,骶前囊肿的切除分两步进行:第一步是在俯卧位PSARP手术中切除,第二步是在仰卧位取石,以去除初次手术中遗漏的病变残余部分。很明显,仰卧位取石术比俯卧位能更好地探索骶前间隙,尤其是在我们的病例中,囊肿位置较深。磁共振成像(MRI)在手术前确定病变的确切性质和范围方面的作用至关重要,在所有情况下都应进行。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
自引率
33.30%
发文量
39
审稿时长
12 weeks
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