title: Unusual presentation of an anterior sacral meningocele: magnetic resonance imaging, multidetector computed tomography, and fistulography findings of bacterial meningitis secondary to a rectothecal fistula.
abstract: An anterior sacral meningocele, a rare congenital anomaly, manifested in a previously healthy 44-year-old woman with findings of meningitis, including headache, vomiting, unconsciousness, and fever. Nontraumatic pneumocephalus, tetraventricular hydrocephalus, fluid-fluid level at the lateral ventricles, and pial enhancement were observed on multidetector computed tomography. A ventricular drainage catheter was placed to decompress the hydrocephalus, and drainage was performed urgently. Escherichia coli was isolated from the drainage material. Whole-spine magnetic resonance imaging and fistulography were undertaken on the third day after admission to evaluate for anal and urinary incontinence and pareses of both upper and lower extremities. Spinal arachnoiditis, tethered cord, dysgenesis of the sacrum, and a rectothecal fistula were demonstrated. Specific antibiotic treatment and surgery for fistula tract excision were performed.
authors: Department of Radiology, Bayindir Hospital, Sogutozu, Ankara, Turkey.
authors: Ali
authors: A
authors: Koksal
authors: Murat
authors: M
authors: Canyigit
authors: Taylan
authors: T
authors: Kara
authors: Aykan
authors: A
authors: Ulus
authors: Hakan
authors: H
authors: Gokbayir
authors: Murat
authors: M
authors: Sarisahin
mesh_terms: D000015:Abnormalities, Multiple / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D016920:Meningitis, Bacterial / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D008588:Meningocele / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D061330:Multidetector Computed Tomography / Q000379:methods*; D012003:Rectal Fistula / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D012445:Sacrococcygeal Region / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery; D013524:Surgical Flaps
chemical_list: D000900:Anti-Bacterial Agents; D003287:Contrast Media