A case of currarino syndrome in an adult woman presenting with refractory chronic constipation.

We present the case of a 25-aged woman who consulted due to refractory chronic constipation and fecal incontinence. She had bowel movements every 7-30 days of increased consistency (1-2 Bristol type stools), together with soiling and passive fecal incontinence (Wexner Scale: 12/20). She had undergone surgery shortly after birth for 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 compressing 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), all consistent with a 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. CS is a congenital disorder characterized by the triad of anorectal malformations, sacral dysgenesis and presacral mass. It is thought to be caused by malformation of the caudal notochord during embryonic development. It is often diagnosed during childhood, although several cases in adults have been reported. This syndrome is associated with a very high rate (95%) of severe chronic and refractory constipation(1). Interestingly, constipation does not appear to be due t...
Source: Revista Espanola de Enfermedades Digestivas - Category: Gastroenterology Tags: Rev Esp Enferm Dig Source Type: research