RESUMO
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Assuntos
Humanos , Feminino , Adulto , Canal Anal/anormalidades , Meningocele/genética , Reto/anormalidades , Sacro/anormalidades , Malformações Anorretais/diagnóstico por imagem , Malformações Anorretais/cirurgia , Espectroscopia de Ressonância Magnética , Incontinência Fecal/complicações , Colonoscopia , Constipação Intestinal/etiologia , Pelve/diagnóstico por imagem , Pelve/patologiaRESUMO
We present the case of a 25-year-old female who presented due to refractory chronic constipation and fecal incontinence. She had bowel movements every 7-30 days with an increased consistency (1-2 Bristol type stools), together with soiling and passive fecal incontinence (Wexner Scale: 12/20). She had previously undergone surgery shortly after birth for an anorectal malformation repair. The colonoscopy and histological study of the rectum were normal. A pelvic magnetic resonance imaging (MRI) was performed, which showed a right pararectal mass that compressed the rectum without invading it. This mass was compatible with a presacral teratoma or hamartoma. MRI also revealed coccyx agenesis and hypoplasia of the last sacral vertebrae (Image 1), which were consistent with Currarino syndrome (CS). The patient received 14 sessions of transcutaneous electrostimulation of the posterior tibial nerve, resulting in an increase in bowel movements (every 3 days) and a reduction in fecal incontinence. She was then referred to surgery for presacral mass removal.
