Tailgut cysts are rare congenital lesions thought to arise from vestiges of the tailgut/postanal gut, which is a primitive gut temporarily present at the most caudal portion of the embryo. The lesions are usually multilocular cysts lined by various types of epithelium in the retrorectal space. We experienced a tailgut cyst in an 18-day-old girl initially presented as an epidermoid cyst like skin lesion in the coccygeal region. MRI showed a well-defined multiloculated cystic mass between the rectum and coccyx, measuring 12x23 mm and markedly hyperintense on T2 weighted images and hypointense on T1-weighted images. The cyst was surgically removed via a posterior sagittal approach and microscopically lined by ciliated columnar, transitional and squamous cells. Tailgut cysts are usually found in adult females, and extremely rarely in neonates. We report a tailgut cyst in a neonate with a review of the literature.
Adult ; Coccyx ; Embryonic Structures ; Epidermal Cyst ; Epithelium ; Female ; Gastrula ; Humans ; Infant, Newborn ; Rectum ; Sacrococcygeal Region ; Skin

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Hirschsprung's disease is one of the most common causes of intestinal obstruction in neonates and infants. The underlying pathology of this disease is the absence of the ganglion cells in both the myenteric (Auerbach's) plexus and the submucosal (Meissner's) plexus. Since Hirschsprung's report in 1886, there have been thousands of papers on Hirschsprung's disease but the cause of the absence of the ganglion cells has not been identified. Hirschsprung's disease can be successfully treated with the Swenson, the Duhamel, and the Soave operations even though the pathogenesis is unknown. With the recent progress of molecular biology and genetics, a more detailed approach to the pathogenesis of Hirschsprung's disease can be undertaken. In addition, there have been recent developments in the surgical approach. In this review, recent advances in surgery for Hirschsprung's disease are presented.
Ganglion Cysts ; Genetics ; Hirschsprung Disease* ; Humans ; Infant ; Infant, Newborn ; Intestinal Obstruction ; Molecular Biology ; Pathology

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Drug Therapy*

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The composition and the structure of the sacrum present the sexual and the racial difference. The variation of the structure is meaningful in the administration of caudal anesthesia which used one of the safest and the most valuable means of local anesthesia. In this study, a morphological investigation of the sacrum in Korean adults was done using 145 dry sacral bones. Non-metrical morphological variations were observed and ten measurements were undertaken. The results of the study were as follows. 1. The five segmented sacrum appeared most commonly (62.1%). Six segmented sacrum appeared 37.2% and the incidence tended to increse according to the age. Four segmented sacrum was noted in one case (0.7%). 2. In 9.7%, deficiences existed in the upper dorsal wall of the sacral canal. In 5.5%, deficiences existed in the middle of the dorsal wall of the sacral canal. 3. The apex of the sacral hiatus was found mostly (28.9%) at the upper third of the body of fifth sacral vertebra. 4. The sacral hiatus was classified into five groups by shape with triangular being the most frequent. 5. There was a significant sexual difference in the antero-posterior and transverse diameters of the first sacral vertebral body, the length of the sacrum, and the length of the sacral hiatus. 6. The average sacral index I was 98.2 in male, and 104.4 in female. Sacral index I was the relationship between the greaster breath to the length of the sacrum. 7. The average sacral index II was 46.6 in male, and 44.8 in female. Sacral index II was the relationship between the first sacral body diameter to the greaster breath of the sacrum. A thorough knowledge of the anatomical features of the dorsum of the sacrum including above results will lead to the decrease in the number of failures in administration of caudal anesthesia.
Adult* ; Anesthesia, Caudal ; Anesthesia, Local ; Female ; Humans ; Incidence ; Male ; Sacrum* ; Spine