La tunisie Medicale - 2017 ; Vol 95 ( n°07 ) : 505-506
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Case: A 41 week male infant, was born to a 28 year-old, gravida 1 para 1 mother who pregnancy was uncomplicated. He was born by cesarean section performed for fetal distress. No resuscitation was required. Apgar scores were 9 and 10 at 1 and 5 minutes, respectively. Birth weight, occipital circumference and length were all in 25th percentile. He was admitted in our unit at birth for posterior spinal dysraphism with a right lumbar hernia.
Physical examination indicated a soft reductible mass at right lateral abdominal wall prominent on crying (Fig 1) with a 3x3 cm open lumbosacral myelomeningocele.
The neurological examination of lower limbs was unremarkable. Anal tone was normal.
Cranial ultrasound showed an Arnold Chiari malformation with triventricularhydrocephalus.
Thoraco-abdominal X- ray revealed hemivertebras at D7 to D10 level with homolateral right rib agenesis. There was a thoraco lumbar scoliosis with convexity to the left (Figure 2).
Magnetic resonance imaging revealed a lumbo-costovertebral syndrome with diastematomyelia and myelomeningocle. The patient was then referred to neurosurgery clinic with an orthopedic follow up.
Conclusion: Lumbocostovertebral syndrome includes hemi-vertebra, congenital absence of ribs, anterior myelomeningocoele and abdominal wall muscular hypoplasia. Our case is the first reporting the combination with a posterior spinal dysraphism and a diastematomyelia.

Figure 1: Right-sided congenital lumbar hernia

Figure 2: Digital X- ray showing a soft tissue shadow under the right costal margin, hemivertebras at D7 to D10 level with homolateral right rib agenesis and a lumbar scoliosis with convexity to the left.

  1. Singh G, Ahuja S, Kumar R, Chandra A, Ojha B, Singh C, Gupta S. Posterior spinal dysraphism with lumbocostovertebral syndrome.Br J Neurosurg. 2010 ; 24:216-8.
  2. Mamta S, Vivek M, Anup M, Vishesh J, Swarup D. Intercostal variant of lumbar hernia in lumbocostovertebral syndrome: our experience with 6 cases. J PediatrSurg2011 ; 46 :1974-77.
  3. Emrah S, Tuğrul T, Halil A , Aysegül C, Tevfik G. Lumbo-costovertebral syndrome with diastematomyelia. PediatrInt2008 ; 50 : 600-2.
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Child treatment diagnosis surgery prognosis Tunisia Children Crohn’s disease Breast cancer screening Cancer epidemiology Ulcerative colitis Osteoporosis prevention
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