Shimauchi-Ohtaki Hiroya, Honda Fumiaki, Nakamura Shunsuke, Yoshimoto Yuhei
Department of Neurosurgery, Gunma University, Maebashi, Gunma, Japan.
Surg Neurol Int. 2022 Jul 22;13:317. doi: 10.25259/SNI_1152_2021. eCollection 2022.
Symptomatic perineural cysts are rare in pediatric patients. Severe bowel dysfunction caused by the perineural cysts at the sacral level is particularly rare in children. Moreover, the long-term outcome of surgery for the perineural cysts in pediatric patients is uncertain. Here, we describe a rare case of perineural cysts originating in the S3 roots in a pediatric patient that manifested as severe constipation.
The case was a 13-year-old girl who presented with intractable vomiting and constipation. She also had low back and buttock pain, urinary incontinence, and periproctal sensory disturbance. Radiological studies revealed bilateral perineural cysts originating from the S3 nerve roots, which were considered to be the cause of her symptoms. Microsurgical decompression of the cysts relieved her intractable bowel dysfunction. There has been no recurrence in the 5 years since surgery.
This case suggests that microsurgery for severe bowel dysfunction due to symptomatic perineural cysts could have a satisfactory long-term outcome in pediatric patients.
有症状的神经周围囊肿在儿科患者中很少见。骶部神经周围囊肿引起的严重肠道功能障碍在儿童中尤为罕见。此外，儿科患者神经周围囊肿手术的长期疗效尚不确定。在此，我们描述了一例罕见的儿科患者，其神经周围囊肿起源于S3神经根，表现为严重便秘。
该病例为一名13岁女孩，出现顽固性呕吐和便秘。她还伴有腰背部和臀部疼痛、尿失禁及肛周感觉障碍。影像学检查显示双侧神经周围囊肿起源于S3神经根，被认为是其症状的病因。囊肿的显微手术减压缓解了她的顽固性肠道功能障碍。术后5年未复发。
该病例表明，对于有症状的神经周围囊肿导致的严重肠道功能障碍，显微手术在儿科患者中可能有令人满意的长期疗效。
