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March 21, 1977

Pelvic Mass in a 12-Year-Old Girl

JAMA. 1977;237(12):1255-1256. doi:10.1001/jama.1977.03270390071032

History  A 12-year-old girl whose menarche occurred approximately six months prior to initial examination had a single episode of menorrhagia. On bimanual examination, a gynecologist found a large, firm but movable pelvic mass. The patient was referred to the hospital for further evaluation.There were no other complaints referable to the pelvic mass. The child had no history of urinary or fecal incontinence; there was no evidence of weakness of the lower extremities or other neurologic abnormalities.Following her admission, cystogram, intravenous urogram, barium enema, air and iophendylate myelograms, and echo B scans of the pelvis were performed. Subsequent to these diagnostic procedures, the patient was taken to surgery. Figure 1 is a plain film of the pelvis, and Fig 2 is a lateral view of the barium-filled rectum. Figure 3 is a frontal view of the pelvis obtained during iophendylate myelography with the patient standing.

Diagnosis  Anterior sacral meningocele.