Advances in Pediatric Surgery

"Currarino syndrome"

Original Articles

[English]

Clinical Experience of Currarino Syndrome: Taehoon Kim, Min Jeong Cho, Dae Yeon Kim, Seong Chul Kim, In Koo Kim; J Korean Assoc Pediatr Surg 2011;17(1):65-71. Published online June 30, 2011; DOI: https://doi.org/10.13029/jkaps.2011.17.1.65

Abstract
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Currarino syndrome is a hereditary syndrome characterized by the triad of a sacral bony defect, presacral mass and anorectal malformation. We retrospectively reviewed 13 Currarino syndrome patients who were treated in our center between 1997 and 2010. Demographic data, initial symptoms, initial diagnosis, pathologic diagnosis of presacral mass, associated anomalies and managements were analyzed. There were 8 boys and 5 girls. Four patients were diagnosed as Currarino syndrome immediately after birth with failure of passage of meconium and abdominal distension. Four patients underwent surgery for imperforate anus immediately after birth and were diagnosed as Currarino syndrome later and underwent reoperation. Three patients were diagnosed during work-up and management with of the tentative diagnosis of Hirschsprung's disease. Diagnosis of the remaining two patients was at the age of 26 months and 9 years and anorectal malformation was not associated. Twelve patients showed hemi-sacrum and one patient showed bilateral sacral subtotal agenesis. Two patients without anorectal malformation underwent presacral mass excision, untethering of spinal cord and repair of myelomeningocele. Six out of 8 patients, excluding 3 that expired or were lost to follow up, with anorectal malformation underwent colostomy, presacral mass excision, untethering of spinal cord, repair of myelomeningocele, posterior sagittal anorectoplasty and colostomy repair. One patient underwent only posterior sagittal anorectoplasty after colostomy. One waits the scheduled operation only with Hegar dilatation. Pathologic examation of presacral masses showed myelomeningoceles in 4 patients, lipomyelomeningoceles in 3 patients and dermoid cyst in one patient. Teratoma was combined in 2 patients. Eight patients needed neurosurgical operation for spinal cord problems. Seven patients had urologic anomalies and two of them underwent operation. Currarino syndrome should be considered as a differential diagnosis in pediatric patients with abdominal distension, constipation and anorectal malformation. For proper evaluation and treatment, a multi-disciplinary approach is recommended.

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[English]

Clinical Characteristics and Treatment of Currarino Syndrome: A Single Institutional Experience: Kim, Hyun Jeong , Ho, In Geol , Ihn, Kyong , Han, Seok Joo , Oh, Jung-Tak; Adv Pediatr Surg 2020;26(2):46-53.; DOI: https://doi.org/10.13029/aps.2020.26.2.46

Abstract
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Purpose
Currarino syndrome is a rare disease, and understanding its clinical characteristics is important because it involves complex anomalies and it requires a multidisciplinary approach for treatment. However, the accumulation of treatment experiences is challenging, and studies on this disease remain insufficient. Our study aimed to review the clinical characteristics and treatment of Currarino syndrome at our institution.
Methods
The medical records of patients diagnosed as Currarino triad or Currarino syndrome at the authors institution from 1997 to 2018 were retrospectively reviewed. Thirteen patients were included in this study.
Results
No significant difference in disease prevalence was observed in terms of sex (male:female, 7:6), and the median age at diagnosis was 7 months (1 day to 35 years). Currarino syndrome was diagnosed during the neonatal period in only one patient, whereas its diagnosis was delayed in the other patients. The most common initial symptom or diagnosis was anorectal malformation (ARM) followed by constipation and sacrococcygeal mass. All patients underwent simple abdominal X-ray and magnetic resonance imaging for the diagnosis of this disease. The most common sacral anomaly was partial sacral agenesis (type III, 62%) followed by hemisacrum (type IV, 38%). The most common presacral mass was mature teratoma. No pathologic malignant features were observed. In ARM, nine patients had anal stenosis, and posterior sagittal anorectoplasty was the most common operative method for ARM. Twelve patients were followed up beyond the age of three, and the median follow-up age was 8.1 years (range: 3.1–30.0 years). Among the 12 patients, 4 patients did not show symptoms of functional abnormality, whereas 8 patients showed constipation, fecal incontinence, urinary dysfunction, or gait disturbance.
Conclusion
The diagnosis of Currarino syndrome could be delayed when sacral bony anomaly and anorectal stenosis are not given attention. A careful follow up is essential because poor long-term functional outcomes are common.