Abstract
A 5-months old girl was admitted complaining of fever and abdominal distension. Constipation had necessitated daily enema after 3 montsh of age. The abdominal distension was caused by the fecal masses and the distended bladder due to a large presacral abscess, which was incised and drained immediately for relieving of urinary and colonic obstruction. Though the abscess being incised, constipation and mucopurulent discharge from the anus have persisted since this episode. Contrast studies of the rectum revieled a presacral mass with arborescent draining fistulas associated with anorectal stenosis. MR imaging suggested that the abscess was tightly adhered to the lower sacrum and the coccyx. At the age of 12, a sacroperineal total resection of the presacral abscess with coccyx for eradicating the abscess and rectal stenosis was performed but, actually, recurred a week later. Seven months later second attempt of total extirpation of the abscess was done combining with resection of the 5th sacrum and the rectum according to original Soave procedure for Hirschsprung disease. However, 4 weeks later mucus discharge was obseved again through the anus. The resected specimen were composed of fibrous tissue and of various-sized mucus containig cysts lined by squamous, transitional and columnar epithelia surrounded with smooth muscle but not cartilage or neural tissues suggesting a teratoma. These histological findings were compatible with tailgut cyst, which predominantly occur in adult female but extremely rare in children.
