We report a 27-year-old female who presented with abdominal distension, saddle anesthesia, and lower back pain. CT and MRI of the abdomen/spine were performed which showed a large anterior sacral meningocele occupying most of the pelvic and abdominal cavity and displacement of their respective contents. Anterior approach was chosen, uterine didelphys was identified and mobilized, meningocele identified and gentle drainage with subsequent resection of the cyst wall and watertight closure was achieved. Subsequent MRI demonstrated resolution of most the sacral meningocele. Patient symptoms improved and are doing well.
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