Anterolateral lumbar lipomyelomeningocele: case report and review of the literature.

Abstract

Meningoceles associated with defects of the abdominal wall are exceedingly rare. One such complex case is presented along with a review of the relevant literature. The current pathophysiological theories and surgical management are discussed. A case of a patient with an anterolateral lumbar lipomyelomeningocele associated with multiple congenital anomalies, including defects in the abdominal wall and urogenital system, is presented. The lipomyelomeningocele presented as an expanding abdominal mass. Ventriculoatrial shunting and two operations to repair the myelomeningocele were performed to control the expanding abdominal mass. This report illustrates that the surgical management of complex lipomyelomeningoceles is similar to the more common types. It also demonstrates that in the infant in whom the intra-abdominal cerebrospinal fluid collection is the primary cause of the symptoms, cerebrospinal fluid shunting may be used to delay the definitive repair until the dura strengthens, thus avoiding the complications of complex repairs of dura with low tensile strength.