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Fetal and Pediatric Pathology Jun 2023The vesico-allantoic cyst is a communication between the fetal bladder and the allantois through a patent urachus. We describe a 17-week of gestational age (WGA) fetus...
The vesico-allantoic cyst is a communication between the fetal bladder and the allantois through a patent urachus. We describe a 17-week of gestational age (WGA) fetus with a 40 x 30 mm vesico-allantoic cyst. At 19 WGA, ultrasound (US) detected bilateral dilatation of renal pelvis (5-6 mm), hydroureters, and hypospadias. Amniotic fluid, umbilical cord flow, and fetal biometry were regular. Due to uncertain prognosis, the parents opted for legal termination of pregnancy. Autopsy confirmed the prenatal findings, also revealing intestinal malrotation and Meckel's diverticulum. Probably an initial urinary tract obstruction occurred, not yet affecting the amniotic fluid volume, but evident as pyelectasis. This case highlights the possibility that genito-urinary and intestinal anomalies may be found in association with the vesico-allantoic cyst.
Topics: Male; Female; Humans; Pregnancy; Urinary Bladder; Urachus; Autopsy; Ultrasonography, Prenatal; Urachal Cyst; Cysts
PubMed: 36369825
DOI: 10.1080/15513815.2022.2143250 -
Medical Ultrasonography Aug 2019This study's aim is to present the specific ultrasonography (US) findings of a series of urachus anomalies.
AIMS
This study's aim is to present the specific ultrasonography (US) findings of a series of urachus anomalies.
MATERIAL AND METHODS
Seven patients with suspected urachal anomalies underwent US scanning initially prior to the surgery and the features of images were reviewed respectively. The clinical data and pathologic results were collected also.
RESULTS
US successfully diagnosed urachal anomalies in 5 patients (5/7, 71.4%) and failed to diagnose in 2 patients (2/7, 28.6%). Patent urachus showed a tubule between the umbilicus and bladder; urachal sinus was a blind focal dilatation at the umbilical end, while vesicourachal diverticulum was an outpouching at the vesical end and urachal cyst was identified as an anechoic structure along the urachus. Non-enhancement in the base and centre was the distinct features of urachus carcinoma by contrastenhanced ultrasonography (CEUS). Using a high frequency probe and CEUS the diagnostic ability of US may be improved.
CONCLUSION
US showed good diagnostic ability in urachal anomalies and combined with CEUS could improve the differential diagnosis.
Topics: Adult; Aged; Diagnosis, Differential; Female; Humans; Infant; Infant, Newborn; Male; Middle Aged; Ultrasonography; Urachal Cyst; Urachus; Urinary Bladder Neoplasms
PubMed: 31476210
DOI: 10.11152/mu-1878 -
Journal of Veterinary Emergency and... Sep 2021Species-related differences in the prevalence, manifestation, and outcome of neonatal illness may impact management practices of neonatal intensive care. The study aimed...
OBJECTIVE
Species-related differences in the prevalence, manifestation, and outcome of neonatal illness may impact management practices of neonatal intensive care. The study aimed to elucidate similarities between disease manifestations and mortality risks of critically ill (CI) neonatal crias and foals admitted to the same referral center.
DESIGN
A comparative, retrospective cohort evaluation of two species (camelid and equine).
SETTING
The study was conducted in a University hospital.
ANIMALS
Two hundred and forty-six CI neonatal crias (January 1999 to May 2016) and 356 neonatal foals (February 2001 to May 2016) under 4-week-old were admitted to a university hospital.
INTERVENTION
All data are presented descriptively and compared between groups using univariate and multivariate analyses.
MEASUREMENTS AND MAIN RESULTS
Female crias (142/246, 57.7%) were significantly overrepresented in comparison to fillies (132/352, 37.5%). Congenital defects and transfer failure of passive immunity were more often observed in neonatal crias, while colic, diarrhea, patent urachus, septic arthritis, and omphalitis were significantly more common in CI foals. Overall survival to discharge (excluding fatal congenital defects) was comparable between crias (174/224; 77.8%) and foals (287/347, 82.1%), while crias (26/48; 54.2%) were more likely than foals (21/60; 35%) to die naturally than undergo euthanasia. Lower respiratory disease and indications for oxygen or IV glucose support increased mortality in the multivariate outcome models of both species. Species-specific adaptations of pediatric diagnostic criteria for sepsis were significantly associated with mortality in the multivariate analysis of patients with complete hematological datasets. However, the diagnosis of systemic inflammatory response syndrome (SIRS) did not retain statistical significance as an independent outcome predictor.
CONCLUSIONS
Lower respiratory disease and oxygen or glucose dysregulation increased mortality irrespective of species. However, despite species-specific differences in disease prevalence, the success of intensive care management was comparable.
Topics: Animals; Animals, Newborn; Camelids, New World; Critical Illness; Female; Horse Diseases; Horses; Prognosis; Retrospective Studies; Sepsis
PubMed: 34324773
DOI: 10.1111/vec.13093 -
Indian Journal of Pathology &... 2023One of the typical complaints in the pediatric population is umbilical discharge. Among the congenital causes, remnants of omphalomesenteric duct or patent urachus are... (Review)
Review
One of the typical complaints in the pediatric population is umbilical discharge. Among the congenital causes, remnants of omphalomesenteric duct or patent urachus are often detected. On a few occasions, multiple types of ectopic tissue are present. We describe histopathologic findings of two cases reported recently at our center as pediatric umbilical lesions with associated ectopic tissue. Histopathology of the excised mass confirmed the patent omphalomesenteric duct with ectopic gastric, duodenal, and colonic mucosa and pancreatic tissue in two patients with the clinical presentation of umbilical discharge. There were no associated congenital anomalies in these patients. The presence of multiple ectopic gastrointestinal mucosa and pancreas in the umbilical mass is unusual. Herein, we report these cases because of its rarity, multiple ectopic tissues, and reviewing the literature of the reported cases of multiple ectopic tissues.
Topics: Humans; Child; Choristoma; Patient Discharge; Vitelline Duct; Stomach; Pancreas
PubMed: 37077097
DOI: 10.4103/ijpm.ijpm_526_21 -
Journal of Equine Veterinary Science Apr 2024In neonatal foals, umbilical remnants can be affected by infectious and non-infectious diseases. This study aimed to retrospectively evaluate historical, management and...
In neonatal foals, umbilical remnants can be affected by infectious and non-infectious diseases. This study aimed to retrospectively evaluate historical, management and clinical factors that may be related to the occurrence of umbilical remnant diseases. Clinical reports of foals born or hospitalized within 24 h of life during the 2017-2021 foaling seasons were reviewed. Forty/183 foals (21.9 %) developed umbilical remnant diseases (URD group), while 143/183 foals (78.1 %) had normal umbilical remnants (NUR group). In the URD group, 24/40 (60 %) had a patent urachus, 16/40 (40 %) omphalo-arteritis, 4/40 (10 %) omphalo-phlebitis, 10/40 (25 %) urachitis, 9/40 (22.5 %) abscess, 3/40 (7.5 %) periumbilical hematoma and 12/40 (30 %) more than one condition. URD frequency was higher in foals hospitalized after birth than in those born at the hospital (17/46 vs 23/137; P = 0.0068), lower in those that had access to the paddock before three days of life (p = 0.0426) and higher in recumbent foals (P = 0.0001). URD occurred more frequently after dystocia (P = 0.0068), prolonged stage II parturition (19±20.51 min vs 13±6.41 in NUR group; P = 0.0279), traction at parturition (P = 0.0005), and in foals with lower APGAR scores (8±1.72 vs 9±0.86 in NUR; P = 0.0063). Sepsis (P = 0.0245), neonatal encephalopathy (P = 0.0014), meconium retention (P = 0.0241) and congenital flexural limb deformities (P = 0.0049) were the most common associated diseases. Umbilical cord (UC) coiling, abnormal UC rupture, umbilical hemorrhage and increased umbilical stump volume occurred more frequently in URD than in NUR group (P = 0.0329, P = 0.0191, P = 0.0007 and P < 0.00001, respectively). Recognition of the identified predisposing historical, management and clinical factors should prompt careful umbilical remnant monitoring in neonatal foals.
Topics: Pregnancy; Female; Animals; Horses; Retrospective Studies; Delivery, Obstetric
PubMed: 38471637
DOI: 10.1016/j.jevs.2024.105045 -
Journal of Ultrasound in Medicine :... Apr 2021
Topics: Humans; Infant, Newborn; Ultrasonography, Doppler, Color; Umbilical Cord; Urachal Cyst; Urachus; Urinary Bladder Diseases
PubMed: 32845039
DOI: 10.1002/jum.15449 -
Urology Case Reports Nov 2021We are reporting an umbilical cyst detected at early trimester which mimicking bladder exstrophy occulta. A 3-cm umbilical cord cyst and a slight ventrally located...
We are reporting an umbilical cyst detected at early trimester which mimicking bladder exstrophy occulta. A 3-cm umbilical cord cyst and a slight ventrally located urinary bladder beneath the cord insertion site was detected at 14th gestational weeks, which decreased in size and disappeared at 28th week. A term female neonate born with a 2-cm defect over the base of the umbilical cord, revealed a patent urachal fistula, and a part of the herniated urinary bladder. Detection of a vanished umbilical cord cyst has to keep aware of, making an immediate definite diagnosis and management of urachal anomaly.
PubMed: 34377676
DOI: 10.1016/j.eucr.2021.101772 -
Cureus Jul 2023Rare developmental anomalies known as urachal remnants are brought on by flaws in the foetal developmental process. However, depending on the location and degree of...
Rare developmental anomalies known as urachal remnants are brought on by flaws in the foetal developmental process. However, depending on the location and degree of incomplete obliteration, the urachus can undergo a variety of urachal anomalies. An umbilical fistulogram and a voiding cystourethrogram both supported the existence of the adult urachal cyst in this case. To treat the sepsis, we provided the patient with antibiotics first, then a surgical procedure. The entire vesico-umbilical tract with the urachal cyst was removed using the open approach. The excised specimen's histology revealed a foreign body giant cell reaction without any indication of malignancy. The presentation and diagnosis of vesico-umbilical urinary fistula (VUUF) in adults can occasionally be difficult. They happen very rarely. So we began putting forward this case for the same reason.
PubMed: 37551248
DOI: 10.7759/cureus.41503 -
Diagnostics (Basel, Switzerland) Dec 2021An allantoic cyst is a rare malformation with a frequency of 3 in 1,000,000 that may be seen antenatally by ultrasound assessment when the connection between the cloaca...
An allantoic cyst is a rare malformation with a frequency of 3 in 1,000,000 that may be seen antenatally by ultrasound assessment when the connection between the cloaca (future bladder) and the allantois fails to regress. A patent urachus that presents as a cyst (allantoic) is usually considered not to be associated with chromosomal abnormalities, but if it is not repaired after birth this leads to complications such as urinary tract infections and stone formation. We present a case of a fetus diagnosed with allantoic cyst at the first trimester ultrasound assessment at 12 weeks gestation. The follow up scans showed a decrease in size of the allantoic cyst with no other obvious major defects and, when invasive testing (amniocentesis with microarray analysis) was performed, a rare microdeletion, 1q21.1q21.2 was identified (1.82 Mb deletion).
PubMed: 34943569
DOI: 10.3390/diagnostics11122332 -
Journal of Medical Case Reports May 2023Abnormalities of the urachus include the patent urachus, cysts, sinus, and fistula. Each of these entities represents a failure of complete obliteration of the urachus....
BACKGROUND
Abnormalities of the urachus include the patent urachus, cysts, sinus, and fistula. Each of these entities represents a failure of complete obliteration of the urachus. Contrary to other urachus anomalies, urachal cysts are usually small and silent unless they are infected. The diagnosis is often made during childhood. A benign noninfected urachal cyst discovered in adulthood is a rare condition.
CASE PRESENTATION
Herein we report two cases of benign noninfected urachal cysts in adults. The first case is a 26-year-old Tunisian white man who presented with complaints of clear fluid draining from the base of the umbilicus evolving for a week, with no other associated symptoms. The other case was 27-year-old Tunisian white woman who was referred to the surgery department with a history of intermittent draining of clear fluid from the umbilicus. The two cases had laparoscopic resection of urachus cysts.
DISCUSSION
Laparoscopy represents a good alternative for the management of persistent or infected urachus, especially when this is suspected, despite a lack of radiological evidence. Laparoscopy in the management of urachal cysts is safe, effective, and offers good cosmesis, with all the advantages of a minimally invasive approach.
CONCLUSION
Managing persistent and symptomatic urachal anomalies requires a wide surgical excision. Such intervention is recommended to prevent symptom recurrence and complications, most notably malignant degeneration. A laparoscopic approach offers excellent outcomes, and is recommended to treat these abnormalities.
Topics: Male; Female; Humans; Adult; Urachal Cyst; Cysts; Laparoscopy; Paranasal Sinuses
PubMed: 37221572
DOI: 10.1186/s13256-023-03944-8