Meningocele sacro anterior oculto

background: the anterior sacral meningocele is a rare form of spinal dysraphism located in the presacral extraperitoneal space. it is generally asymptomatic and appears as a small pelvic mass. case description: we present a case of a 10 year-old male that developes a bacteria meningitis because of a pararectal abscess that is connected with an anterior sacral meningocele. we successfully treated it using a posterior approach. conclusion: the aim of the surgery is to repair the dural defect and to obliterate the communication between the thecal sac and the herniation defect. the posterior approach is the simplest and most effective surgical technique because the lower risk of neurological injury than the anterior approach.