title: Successful management of a giant anterior sacral meningocele with an endoscopic cutting stapler: case report.
abstract: 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.
authors.affiliation: Department of Surgery, Division of Neurosurgery, Centre Hospitalier de l'Université de Montréal, Hôpital Notre-Dame, Montreal, Quebec, Canada.
authors.forename: Tarek P
authors.initials: TP
authors.lastname: Sunna
authors.affiliation: Department of Surgery, Division of Neurosurgery, Centre Hospitalier de l'Université de Montréal, Hôpital Notre-Dame, Montreal, Quebec, Canada.
authors.forename: Harrison J
authors.initials: HJ
authors.lastname: Westwick
authors.affiliation: Department of Surgery, Division of Neurosurgery, Centre Hospitalier de l'Université de Montréal, Hôpital Notre-Dame, Montreal, Quebec, Canada.
authors.forename: Fahed
authors.initials: F
authors.lastname: Zairi
authors.affiliation: Department of Surgery, Division of Neurosurgery, Centre Hospitalier de l'Université de Montréal, Hôpital Notre-Dame, Montreal, Quebec, Canada.
authors.forename: Ilyes
authors.initials: I
authors.lastname: Berania
authors.affiliation: Department of Surgery, Division of Neurosurgery, Centre Hospitalier de l'Université de Montréal, Hôpital Notre-Dame, Montreal, Quebec, Canada.
authors.forename: Daniel
authors.initials: D
authors.lastname: Shedid
mesh_terms: D000328:Adult; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008588:Meningocele / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D051437:Renal Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D012447:Sacrum / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome
keywords: ASM = anterior sacral meningocele; congenital; hydronephrosis; meningocele; renal failure; spina bifida