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Abdominal Radiology (New York) Dec 2019Urachal anomalies are classified into four types depending on the level of persistence of the embryonic urachal remnants between the urinary bladder and the umbilicus:... (Review)
Review
Urachal anomalies are classified into four types depending on the level of persistence of the embryonic urachal remnants between the urinary bladder and the umbilicus: patent urachus, umbilical-urachal sinus, urachal cyst, and vesico-urachal diverticulum. Due to the increasing use of cross-sectional imaging, urachal anomalies are frequently detected as incidental findings. Imaging plays a pivotal role in the initial diagnosis, evaluation of complications, treatment follow-up, and long-term surveillance of patients with urachal anomalies. Different urachal anomalies demonstrate characteristic imaging features that aid in a timely diagnosis and guide treatment. A patent urachus is visualized as an elongated tubular structure between the umbilicus and the urinary bladder. While umbilical-urachal sinus appears as focal dilatation at the umbilical end of the urachal remnant, the vesico-urachal diverticulum presents as a focal outpouching of the urinary bladder at anterosuperior aspect. Urachal cysts are identified as midline fluid-filled sacs most frequently located near the dome of the urinary bladder. Untreated urachal anomalies could progress into potential complications, including infection and malignancy. Knowledge regarding imaging features of urachal anomalies helps in timely diagnosis, treatment, follow-up, and early detection of complications.
Topics: Contrast Media; Diagnosis, Differential; Humans; Incidental Findings; Urachus; Urogenital Abnormalities
PubMed: 31478084
DOI: 10.1007/s00261-019-02205-x -
The Veterinary Clinics of North... Apr 2022Urinary incontinence results from disorders of the lower urinary tract or neurologic diseases either of the nerve supply to the bladder/urethra or within the central... (Review)
Review
Urinary incontinence results from disorders of the lower urinary tract or neurologic diseases either of the nerve supply to the bladder/urethra or within the central nervous system. Congenital causes include patent urachus and ectopic ureter. Coordination of lower urinary tract function involves the interaction of both the sympathetic and parasympathetic system as well as somatic branches of the central nervous system. Well-recognized causes of incontinence include equine herpes virus 1 myeloencephalopathy, polyneuritis equi (neuritis of the cauda equina), and sacral/coccygeal trauma. Idiopathic bladder paralysis is characterized by bladder paralysis and sabulous cystitis in the absence of overt neurologic deficits.
Topics: Animals; Horse Diseases; Horses; Urinary Bladder Diseases; Urinary Bladder, Neurogenic; Urinary Incontinence; Urinary Tract Infections
PubMed: 35282960
DOI: 10.1016/j.cveq.2021.11.006 -
Medicina (Kaunas, Lithuania) Nov 2022Patent urachus is a type of urachal anomaly in which the urachus does not tail off but remains connected to the bladder in the umbilicus. The prevalence of patent... (Review)
Review
Patent urachus is a type of urachal anomaly in which the urachus does not tail off but remains connected to the bladder in the umbilicus. The prevalence of patent urachus is very low. Herein, we report a case of patent urachus ruptured and exposed to amniotic fluid in utero. In this case, the size decreased after the second trimester, which was thought to be due to rupture in utero. After delivery, patent urachus was confirmed by inserting a foley catheter, which runs through a ruptured cyst on umbilical cord insertion. The day after delivery, the neonate underwent surgical excision of the urachal cyst and closing umbilicus. The mechanism of patent urachus rupture is unknown. As the fetus matures, it is thought that the higher intravesical pressure may affect the rupture of the cyst. Patent urachus could be ruptured in the uterus spontaneously, and surgical correction is needed. Therefore, prenatal differential diagnosis is important.
Topics: Infant, Newborn; Pregnancy; Female; Humans; Urachus; Urachal Cyst; Pregnancy Trimester, Second; Urinary Bladder; Ultrasonography, Prenatal
PubMed: 36363578
DOI: 10.3390/medicina58111621 -
Folia Medica Cracoviensia Dec 2023The urachus is a tubular structure that is apparent on the third week and connects the ventral cloaca to the yolk sac, as a progression from the allantois. Following the...
The urachus is a tubular structure that is apparent on the third week and connects the ventral cloaca to the yolk sac, as a progression from the allantois. Following the normal regression procedure, the urachus remains as the median umbilical ligament. Urachal remnants are present in 1.03% of paediatric patients while in 92.5% of cases represent incidental findings. Urachal anomalies are classified in four types as patent urachus (50-52%), urachal sinus (15%), urachal cyst (30%) and urachal diverticulum (3-5%). Ultrasound scan is the most commonly performed diagnostic imaging study. In case of symptomatic urachal remnants, surgical excision is indicated. Asymptomatic urachal remnants that are diagnosed at the neonatal period or early infancy should be watched up to 6 months of age, as they are likely to resolve. In persistent or symptomatic urachal remnants there is a risk of inflammation or even malignancy development, therefore we believe that there is indication for preventive surgical excision that may be performed either open or laparoscopically or by robot-assisted laparoscopy.
Topics: Infant, Newborn; Humans; Child; Urachus; Urachal Cyst; Ultrasonography; Laparoscopy; Inflammation
PubMed: 38578347
DOI: 10.24425/fmc.2023.148760 -
Clinical Imaging Jun 2024The space of Retzius is an important anatomic location for pathology. Pathology in the space of Retzius is more common than previously believed, especially as more cases... (Review)
Review
The space of Retzius is an important anatomic location for pathology. Pathology in the space of Retzius is more common than previously believed, especially as more cases are discovered with increased use of cross-sectional imaging. Knowledge of the anatomy of the Space of Retzius is crucial for identifying and distinguishing between benign and pathological findings. This paper uses several case examples to discuss benign etiologies, including normal tissue or a foreign body. The paper also demonstrates a case series with pathologic findings in the Space of Retzius under the broad categories of infection, neoplasm, hemorrhage, or urine extravasation. Understanding of the anatomy and these example cases can improve the diagnostic accuracy of radiologists.
Topics: Humans; Tomography, X-Ray Computed; Magnetic Resonance Imaging
PubMed: 38593675
DOI: 10.1016/j.clinimag.2024.110137 -
Polski Merkuriusz Lekarski : Organ... Aug 2022Urachus is a tubular connection between the umbilical cord and the bladder of developing foetus and tends to degenerate during perinatal period to form an impatent...
UNLABELLED
Urachus is a tubular connection between the umbilical cord and the bladder of developing foetus and tends to degenerate during perinatal period to form an impatent median umbilical ligament. Failure to degenerate results in patent canal between the bladder and the umbilicus called "patent urachus" which may lead to serious of symptoms such as umbilical discharge, dermatitis, umbilical infection, abdominal pain or recurrent urinary tract infections. The Tenckhoff catheter is a tube used to perform peritoneal dialysis that is inserted through abdominal wall into peritoneum either by open surgery, minilaparotomy, laparoscopy or needle-guidewire technique.
A CASE REPORT
A 57-years old man was admitted to the hospital after implantation of Tenckhoff catheter by percutaneous technique in order to start peritoneal dialysis treatment. His medical history was: endstage chronic kidney disease (diabetic nephropathy), type 2 diabetes and hypertension. After the infusion of dialysate the patient experienced sudden urine pressure and passed significant amount of urine. The CT scan showed the tip of catheter being placed inside the urinary bladder. The catheter was introduced through the abdominal wall into the canal of previously undiagnosed patent urachus. The decision about re-surgery was made to stitch urachal remnants and place new the Tenckhoff catheter. Awaiting the surgery patient temporary started hemodialysis. In ongoing observation patient did not present any complications associated with peritoneal dialysis treatment.
Topics: Diabetes Mellitus, Type 2; Female; Humans; Kidney Failure, Chronic; Laparoscopy; Male; Middle Aged; Peritoneal Dialysis; Pregnancy; Urachus
PubMed: 36086985
DOI: No ID Found -
The British Journal of Radiology Jun 2020The urachus is a fibrous tube extending from the umbilicus to the anterosuperior bladder dome that usually obliterates at week 12 of gestation, becoming the median... (Review)
Review
The urachus is a fibrous tube extending from the umbilicus to the anterosuperior bladder dome that usually obliterates at week 12 of gestation, becoming the median umbilical ligament. Urachal pathology occurs when there is incomplete obliteration of this channel during foetal development, resulting in the formation of a urachal cyst, patent urachus, urachal sinus or urachal diverticulum. Patients with persistent urachal remnants may be asymptomatic or present with lower abdominal or urinary tract symptoms and can develop complications. The purpose of this review is to describe imaging features of urachal remnant pathology and potential benign and malignant complications on ultrasound, CT, positron emission tomography CT and MRI.
Topics: Abscess; Adult; Aged; Cell Transformation, Neoplastic; Child; Female; Fistula; Humans; Male; Medical Illustration; Middle Aged; Tomography, X-Ray Computed; Ultrasonography; Umbilicus; Urachal Cyst; Urachus; Urinary Bladder Fistula; Young Adult
PubMed: 32045264
DOI: 10.1259/bjr.20190118 -
JFMS Open Reports 2020A 12-week-old intact male domestic shorthair kitten presented for dysuria. The patient had a urethral obstruction that was relieved with urinary catheter placement. A...
CASE SUMMARY
A 12-week-old intact male domestic shorthair kitten presented for dysuria. The patient had a urethral obstruction that was relieved with urinary catheter placement. A cutaneous opening at the umbilicus was identified. Three-view abdominal radiographs and a contrast study revealed a patent urachus with no evidence of urine leakage into the abdomen. An exploratory laparotomy was performed that confirmed a patent urachus, which was excised, and cystic and urethral calculi, which were removed via cystotomy. The patient recovered well from surgery, with a 12 h period of stranguria occurring 2 days postoperatively, attributed to residual inflammation. Calculi analysis revealed struvite stones, likely secondary to infection and inflammation. At the time of writing, 3 months postoperatively, the kitten had one episode of hematuria and inappropriate urination, which resolved with a short course of non-steroidal anti-inflammatory drugs, but had been otherwise been asymptomatic and healthy.
RELEVANCE AND NOVEL INFORMATION
To our knowledge, this is the first report of urolithiasis and patent urachus in a pediatric feline patient. Based on the occurrence of struvite stones in the presence of a patent urachus in an animal of this age, we suspect that chronic infection and inflammation led to the development of urolithiasis. Correction of the patent urachus resulted in almost complete resolution of clinical signs and no crystal formation was appreciated on recheck urinalysis.
PubMed: 32231787
DOI: 10.1177/2055116920909920 -
Tierarztliche Praxis. Ausgabe G,... Aug 2021Urachal patency is an umbilical disease in newborn foals. Etiologically, either the closure of the urachus remains absent after birth (persistent urachus) or the urachus... (Review)
Review
Urachal patency is an umbilical disease in newborn foals. Etiologically, either the closure of the urachus remains absent after birth (persistent urachus) or the urachus was already closed and reopens at a later time (patent urachus). The most common causes of patent urachus are congenital defects, tearing of the navel above the predilection site, trauma, increased intravesical or abdominal pressure and umbilical infections. Patent urachus occurs more frequently in premature or weak and immunocompromised foals. Colts are more often affected than fillies. Typical clinical signs are apparent immediately after birth (persistent urachus) or 7-14 days postpartum (patent urachus). These include either dripping or a stream of urine through umbilicus during micturition as well as a moist umbilical area. The diagnosis is usually unambiguous. Typical laboratory findings are not described for patent urachus. Conservative treatment such as obliteration, cauterization or cryosurgery may be employed in cases lacking an inflammation of the urachus or other umbilical structures and when the urachal lumen measures less than 6 mm. Surgical treatment is indicated in foals with large urachal lumen, an umbilical infection or sepsis as well as when no therapeutic success is attained after a conservative treatment of 5-7 days. In most cases, prognosis is good, however complications such as umbilical inflammation, disseminating infections, and secondary joint diseases may significantly impair prognosis.
Topics: Animals; Female; Horse Diseases; Horses; Male; Sepsis; Umbilicus; Urachal Cyst; Urachus
PubMed: 34425617
DOI: 10.1055/a-1523-2711