title: Currarino's syndrome in twins presenting as neonatal intestinal obstruction--identical presentation in non-identical twins.
abstract: We report a case of non-identical twins who presented with identical neonatal intestinal obstruction with features of anorectal stenosis, presacral mass and sacral anomaly consistent with Currarino's syndrome or triad. Plain sacral radiograph, contrast enema and MRI were diagnostic. Initial management involved a defunctioning colostomy followed by a posterior sagittal anorectoplasty with excision of the teratoma ± anterior sacral meningocele and finally closure of colostomy in a staged multidisciplinary approach. The twins' father is also affected with features of Currarino's syndrome but was diagnosed during family screening. Currarino's syndrome presenting with identical neonatal low intestinal obstruction in a non-identical set of twins is rare and interesting. Antenatal diagnosis of Currarino's syndrome is difficult and may prove to be a challenge even in the postnatal period. Sacral spine radiograph, contrast enema and MRI are diagnostic. Management requires high index of suspicion, low threshold for MRI and multidisciplinary staged approach.
authors.affiliation: Department of Paediatric Urology, University College London Hospitals NHS Foundation Trust, London, UK Department of Paediatric Urology, Great Ormond Street Children Hospital NHS Trust, London, UK.
authors.forename: Ramnik V
authors.initials: RV
authors.lastname: Patel
authors.affiliation: Neonatal and Paediatric Surgery, ICH and Great Ormond Street Hospital, London, UK.
authors.forename: Paolo
authors.initials: P
authors.lastname: De Coppi
authors.affiliation: Specialist Neonatal and Paediatric Surgery (SNAPS) Department, Great Ormond Street Hospital, London, UK.
authors.forename: Edward
authors.initials: E
authors.lastname: Kiely
authors.affiliation: Specialist Neonatal and Paediatric Surgery (SNAPS) Department, Great Ormond Street Hospital, London, UK.
authors.forename: Agostino
authors.initials: A
authors.lastname: Pierro
mesh_terms: D000015:Abnormalities, Multiple; D001003:Anal Canal / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D000071056:Anorectal Malformations; D001006:Anus, Imperforate; D003125:Colostomy; D004065:Digestive System Abnormalities / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D004200:Diseases in Twins; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases; D007415:Intestinal Obstruction / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008588:Meningocele; D011859:Radiography; D012007:Rectum / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D012447:Sacrum / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D013131:Spine / Q000000981:diagnostic imaging; D013577:Syndrome; D013595:Syringomyelia / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D013724:Teratoma / Q000209:etiology / Q000601:surgery; D014429:Twins, Dizygotic