The authors report a case of thoracic meningomyelocele. The patient had not have any presenting symptoms until adult age. We confirmed it with radiological(postmyelography CT and MRI) and pathological diagnosis. Pre-, post- and intraoperative SSEP(somatosensory evoked potential) monitoring were performed. Characteristically, the mass contained accessory cord which attached to inner cyst wall with multiple fibrous bands. Meningomyelocele was completely removed without any neurologic sequelae.
Adult ; Diagnosis ; Humans ; Meningomyelocele*

A myelomeningocele with spina bifida in the thoracic region is a relatively rare, congenital anomaly. This case, which we have experienced recently, is reported with a review of the literatures.
Meningomyelocele* ; Spinal Dysraphism

No abstract available.
Arnold-Chiari Malformation* ; Meningomyelocele*

No abstract available.
Biofeedback, Psychology* ; Humans ; Meningomyelocele*

The Currarino triad is a unique complex of congenital anomalies including anorectal malformation, scral bonyabnormality, and presacral mass. The usual symptomatology is constipation due to anorectal stenosis. Threepatients with this triad confirmed by surgical operation during recent two yeas in Seoul National Universitychildren's Hospital were presented with a brief review of clinical features, unique radiologic appearance andpostulated pathophysiology. The presacral mass was a mature teratoma in the first patient, alipomyelomeningocele-epidermoid inclusion cyst in the second patient, and myelomeningocele in the third patient. Acorrect diagnosis of the Currarino triad by radiologists is important, and may help the phsicians to investigatedetailed family history and associated anomalies and to establish adequate surgical plans.
Constipation ; Constriction, Pathologic ; Diagnosis ; Humans ; Meningomyelocele ; Seoul ; Teratoma

Vesico-enteric fistulas may develop between the bowel and urinary tract due to inflammatory disease of the bowel, neoplasm of either bowel or urinary tract and occasionally trauma. The fistula rarely, if ever, closes spontaneously. We experienced a case of vesico-enteric fistula developed in a 11 years old girl who had myelomeningocele accompanied with neurogenic bladder. Operation was delayed due to her poor hepatic function and urethral Foley catheter was indwelled for 4 weeks. Thereafter follow-up voiding cystogram showed no fistula and barium study of colon revealed nonspecific finding.
Barium ; Catheters* ; Child ; Colon ; Female ; Fistula* ; Follow-Up Studies ; Humans ; Meningomyelocele ; Urinary Bladder, Neurogenic ; Urinary Tract

The prenatal diagnosis of spina bifida includes the combined use of maternal serum alpha-fetoprotein (MSAFP) screening and fetal sonography. On ultrasonogram, spina bifida is characterizd by visualization of the spinal defect and associated cranial abnomalities: the Lemon sign, the Banana sign, ventriculomegaly, small biparietal diameter, and obliteration of the cisterna magna. We should now be able to rely on ultrasound as the main technique for diagnosis of spina bifida when MSAFP is elevated. Recently, we have experienced three cases of spina bifida diagnosed with meningomyelocele, lemon sign, banana sign and ventriculomegaly on ultrasonogram at respectively 18+3, 18, and 18+6 weeks of gestation. We present these cases with a brief review of literatures.
alpha-Fetoproteins ; Cisterna Magna ; Diagnosis ; Mass Screening ; Meningomyelocele ; Musa ; Pregnancy ; Prenatal Diagnosis ; Spinal Dysraphism* ; Ultrasonography*

"The prenatal diagnosis of spine bifida include the combined use of maternal serum alpha-fetoprotein (MSAFP) screening and fetal sonography. Sonographically, spina bifida is characterized by direct signs of the visualization of the spinal defect, and indirect signs of the cranial markers : the lemon sign, the banana sign, and ventriculomegaly. These ultrasonographic signs are more accurate in defining the cranial malformations associated with spina bifida than evaluation of the spine. Recently, three cases of spina bifida which was diagnosed as ""splaying"" of the posterior ossification centers, meningomyelocele sac at the lumbosacral area, lemon sign, banana sign and ventriculomegaly by ultrasonography at 21+2 gestational weeks in a 32 years old nullipara, at 21+2 gestational weeks in a 26 years old nullipara, at 23+6 gestational weeks in a 26 years old multipara were experienced at our department. We present this cases with a brief review of literatures"
Adult ; alpha-Fetoproteins ; Humans ; Mass Screening ; Meningomyelocele ; Musa ; Prenatal Diagnosis ; Spinal Dysraphism* ; Spine ; Ultrasonography

PURPOSE: This study was undertaken to ascertain if the Churchill's classification of the bladder, in children with spina bifida, reflects the characteristic clinical manifestation of the patients, and can therefore help to determine the best corrective surgical procedure in patients with spina bifida. MATERIALS AND METHODS: The patient population consisted in 148 lipomeningomyelocele and 92 meningomyelocele patients. Patient bladders were classified, according to Churchill, based on the filling, holding and voiding abnormalities(types I-V). The renal damage was expressed as grades A-D, according to the severity of the defect. RESULTS: Ninety patients were classified as type I and 5(6%) of them had renal damage. Thirty-three patients were classified as having type II and 7(21%) of them had renal damage. Five patients were classified as having type III, all with normal kidneys. Of these 5 patients, 2 received ileal augmentation and anti-incontinence surgery. 55 patients were classified as having type IV bladders and renal damage was found in 11(20%). Fifteen patients received augmentation and anti-incontinence surgery simultaneously. Two patients underwent ileal augmentation only, but incontinence continued postoperatively. Fifty-seven patients were classified as having type V bladder, and renal damage was found in 25(44%), and 15 patients received augmentation. All the type V patients that had augmentation cystoplasty maintained their continence state postoperatively. CONCLUSIONS: Neurogenic bladders in pediatric patients with spina bifida can be classified by Churchill's classification. The individual types showed characteristics of the clinical state. This classification seems to help in determining the best corrective surgical procedure in individual neurogenic bladder types of pediatric patients with spina bifida.
Child ; Classification* ; Humans ; Kidney ; Meningomyelocele ; Spinal Dysraphism* ; Urinary Bladder ; Urinary Bladder, Neurogenic*

PURPOSE: As problem have developed with the right colonic antegrade enema procedure (Malone's procedure/Monti's retubularized ileocolostomy), left colonic antegrade continence enema (LACE) procedure, in which retubularized ileum or sigmoid colon is anastomosed into the sigmoid colon, has gained popularity. The aim of the study was to describe our experience with the LACE procedure. METHODS: We retrospectively reviewed 19 LACE procedures that were performed at the Yonsei University Colllege of Medicine Hospital (Seoul, Korea) from March 2001 to March 2005. RESULTS: Male-to-female ratio was 11 : 8, with median age of 10 years (range, 3~34 years). Most common diagnosis was meningomyelocele (78.9%, 15/19). The median total follow-up period was 23 months (range, 3~37 months); median antegrade continence enema volume used was 600 ml (range, 250~1,500 ml); and median transit time was 30 minutes (range, 15~60 minutes). Patients performed antegrade continence enema with an average of once every 2 days (range, 0.3~3 days). Social continence was achieved in 14 patients (73.7%). Regurgitation of fecal material through stoma was not reported at all in 17 patients (89.5%). CONCLUSION: We recommend LACE as the procedure of choice for patients with congenital malformation or any other condition predisposing to fecal incontinence or constipation intractable to conventional treatment.
Colon* ; Colon, Sigmoid ; Constipation ; Diagnosis ; Enema* ; Fecal Incontinence ; Follow-Up Studies ; Humans ; Ileum ; Meningomyelocele ; Retrospective Studies