What Is an Enterocele?

Intestinal cysts, also known as neural tube and gastrointestinal cysts, are mostly located in the spinal canal. The main cause is ectopic embryonic residual tissue, which is a congenital disease.

Intestinal cyst

Intestinal cysts, also known as neural tube and gastrointestinal cysts

Spinal canal intestinal cysts, also known as neural tube and gastrointestinal cysts, are congenital diseases that arise from the development of ectopic residual tissues from the foregut during embryonic development and destroy the mesoderm in the spinal canal. Rarely clinically. According to Fortund, it accounts for 12% of spinal cystic disorders. In recent years, with the continuous development of imaging, domestic reports on the disease have gradually increased. And get effective treatment.

The disease is prevalent in children and adolescents, with a minimum age of 11 days after birth and rarely older than 40 years of age. Generally more men than women, the ratio of men and women is (2-3): 1.

The first symptom is the spinal nerve root pain at the site of the cyst. There are many bilateral neck pains, and neck movement is restricted and neck resistance. About half of the patients have recurrent symptoms, that is, intermediate remission and exacerbations, accompanied by low fever. This remission and recurrence may be the periodic rupture of the cyst, or the extravasation of the cyst fluid to relieve the symptoms. Later, due to the increased secretion of the epithelial cells of the cyst wall, the cyst gradually increased and the spinal cord was compressed again to reproduce the symptoms. Some patients have an acute onset, and the condition develops rapidly, and limb sensation, dyskinesia, and sphincter dysfunction often occur in a short period of time. In particular, there are many dyskinesias, paraplegia or quadriplegia.

The disease is often accompanied by other congenital malformations, most of which are deformities of the corresponding parts of the spine, such as skull depression, atlantooccipital deformity, vertebral fusion, spina bifida, hemivertebra, meningocele, scoliosis, etc. Digestive and respiratory malformations, such as intestinal arm ectopic, esophageal or airway diverticulum, bronchial and mediastinal cysts, mediastinal or occipital squamous defects. In addition, those with high neck can also be accompanied by cerebellar subtonsillar hernia deformities, see typical cases in this section.

The diagnosis of this disease can be based on whether the patient is a male child or adolescent; the onset of root pain causes spinal cord compression to occur relatively quickly; the course of the disease has recurrent episodes that are separated by months or years, and if other congenital malformations are found, it should be Considering gut-derived cysts, spinal angiography or MRI should be done in time to confirm the diagnosis. In the differential diagnosis, it is necessary to pay attention to distinguishing from the following intraspinal cystic diseases: Arachnoid cysts are more common in young people, more women than men, and are more common on the back of the thoracic spinal cord. Feeling of both lower limbs. Dyskinesia. The symptoms are obvious or worse in the sitting or standing position, and the symptoms are relieved in the lying position. The spinous process of the lesion had tenderness and throbbing pain. Cerebrospinal fluid pressure is not high, there is incomplete or complete obstruction of the spinal lumen, the number of cells is normal, and the protein content is slightly increased. There were no changes in the plain radiographs of the spine. Myelography showed a cystic filling defect, negative in the prone position, positive in the supine position, and shadows of the cysts only appeared in the supine or upright position. MRI showed spinal dorsal cystic occupancy on the dorsal spinal cord, and a T1-weighted image was a signal shadow of the strength of a piece of soft tissue. The weighted image is a high-intensity signal, and there is no enhancement in enhanced scanning. Spinal arachnoiditis starts slowly, with symptoms ranging from mild to severe. It usually starts after trauma or fever. The sensory disturbance is relatively obvious, the distribution of sensory change areas is often irregular, and there is no obvious sensory disturbance plane. Dyskinesia and sphincter disorders are generally mild or insignificant. The course of disease is mostly passive and has a longer remission period, showing multifocal signs. Myelography showed scattered dots, flakes, or lacrimal tears and cyst filling defects. Dermatoid cysts or epidermoid cysts are more common in children and occur in the cone and pony tail below the lower thoracic spine. Mostly located in the spinal cord outside the spinal cord, often with spina bifida. The cyst has various skin abnormalities such as sinus, hairy, and vascular nevus. Cerebrospinal fluid protein content increased significantly. X-ray examination can show enlarged spinal canal, pedicle flattening, and inward pressure marks on the posterior edge of the vertebral body. Dermatoid cysts contain proteins in MRI, so the signal on T1 weighted images is slightly higher than that of cerebrospinal fluid, and the signal on T2 weighted images is high, similar to cerebrospinal fluid. The signals of epidermoid cysts on T1 and T2 weighted images are similar to cerebrospinal fluid, but the cysts have smooth borders and are round or oval, showing compression of the spinal cord and horsetail.

Surgical removal of cysts is the only effective treatment for this disease, so once the diagnosis is confirmed, surgery should be performed in time. Microsurgical techniques should be used to carefully separate adhesions and protect the spinal nerve and spinal cord. If the cyst is completely removed, supplemented with neurotrophic therapy before and after surgery, often satisfactory results can be obtained. Surgical treatment of this disease is relatively safe, rarely recurrence after complete removal, most of them can be completely cured, and the prognosis is good.