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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 -
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 -
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 -
Annals of the Royal College of Surgeons... Mar 2020Diverticular disease is a common clinical condition among Western populations, which increases with age. It can present in a variety of manners and has myriad of...
Diverticular disease is a common clinical condition among Western populations, which increases with age. It can present in a variety of manners and has myriad of potential disease complications. We present a rare case of an adult patient with an extraperitoneal complications of a diverticular perforation presenting with facial swelling due to a colo-urachal fistula associated with a patent urachal remnant. Perforation should be considered in patients presenting with surgical emphysema with background of diverticular disease.
Topics: Anaphylaxis; Diverticulitis, Colonic; Edema; Face; Fistula; Humans; Intestinal Fistula; Intestinal Perforation; Male; Middle Aged; Urachus
PubMed: 31697162
DOI: 10.1308/rcsann.2019.0143 -
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 -
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 Surgical Case Reports Jul 2019A urachus is a vestigial tubular structure that connects the urinary bladder to the allantois during early embryonic development. Urachal remnants are classified as...
A urachus is a vestigial tubular structure that connects the urinary bladder to the allantois during early embryonic development. Urachal remnants are classified as patent urachus, urachal sinus, urachal cyst, and urachal diverticulum. Ten patients with urachal remnants underwent surgery at our institution between 2015 and 2019. Six patients had a urachal sinus, and four had a urachal diverticulum. Two patients with urachal sinus underwent excision of the urachal remnant, from the umbilicus to the urinary bladder, using an umbilical approach. The other four patients with urachal sinus underwent laparoscopic surgery with excision of the urachal remnant, from the umbilicus to the urinary bladder. All patients with urachal diverticulum underwent open excision of the diverticulum through a Pfannenstiel incision. Pathologic examination of all urachal remnants showed no evidence of neoplasm and complete excision. All patients had an uneventful postoperative course and are doing well.
PubMed: 31384429
DOI: 10.1093/jscr/rjz222