CC BY 4.0 · European J Pediatr Surg Rep 2019; 07(01): e86-e89
DOI: 10.1055/s-0039-3399533
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Currarino Triad: Importance of Preoperative Magnetic Resonance Imaging

Amr AbdelHamid AbouZeid
1  Department of Pediatric Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt
,
Shaimaa Abdelsattar Mohammad
2  Department of Radiodiagnosis, Ain Shams University, Cairo, Egypt
,
Mohammad Seada
3  Department of Pediatric Surgery, Benha Specialized Children Hospital, Benha, Egypt
,
Khaled Khiamy
3  Department of Pediatric Surgery, Benha Specialized Children Hospital, Benha, Egypt
,
Radwa Gamal
4  Genetics Unit, Department of Pediatrics, Ain Shams University, Cairo, Egypt
› Author Affiliations
Further Information

Publication History

16 May 2019

17 September 2019

Publication Date:
22 November 2019 (online)

  

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.