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Journal of the Belgian Society of... 2023Infected urachal cysts are a rare cause of abdominal complaints and can be accurately diagnosed by abdominal ultrasound and computed tomography (CT).
Infected urachal cysts are a rare cause of abdominal complaints and can be accurately diagnosed by abdominal ultrasound and computed tomography (CT).
PubMed: 36817568
DOI: 10.5334/jbsr.3029 -
Journal of the Chinese Medical... Jan 2023To explore the extraperitoneal laparoscopic urachal mass excision technique and its safety and efficacy in treating urachal mass. (Observational Study)
Observational Study
BACKGROUND
To explore the extraperitoneal laparoscopic urachal mass excision technique and its safety and efficacy in treating urachal mass.
METHODS
Baseline characteristics were collected from patients who underwent surgery to diagnose a urachal cyst or abscess in our hospital between January 2020 and August 2021. The full-length of the urachus and part of the top bladder wall were completely removed through the extraperitoneal approach. Patient outcomes were collected to evaluate surgical safety and efficacy, including operation time, intraoperative blood loss, drainage tube removal time, length of stay (LOS), and postoperative complications.
RESULTS
All 20 surgeries were successfully performed laparoscopically, and no case was converted to open surgery. The mean body mass index of the patients was 24.6 ± 2.2. The mean patient age was 49.3 ± 8.7 years. The mean size of the cysts was 3.0 ± 0.4 cm. The mean operation time was 56.3 ± 12.0 min. The mean intraoperative blood loss was 28.0 ± 6.4 mL. The mean drainage tube removal time was 3.0 ± 0.5 days. The mean LOS was 5.2 ± 0.4 days. The mean follow-up was 13.4 ± 2.1 months. No postoperative complications were observed during the follow-up period. The short-term follow-up and small patient cohort limited our outcome evaluation.
CONCLUSION
Our results indicated that the extraperitoneal laparoscopic approach was a safe and effective method to treat urachal mass. Given the limitations of the study, further multiple and larger sample-sized trials are required to confirm our findings.
Topics: Humans; Adult; Middle Aged; Urachus; Blood Loss, Surgical; Retrospective Studies; Urachal Cyst; Laparoscopy; Postoperative Complications
PubMed: 36599140
DOI: 10.1097/JCMA.0000000000000834 -
Open Veterinary Journal 2022The urachus is an embryonic remnant occurring as a result of the involution of the allantoic duct and the ventral cloaca. This canal becomes progressively obliterated...
BACKGROUND
The urachus is an embryonic remnant occurring as a result of the involution of the allantoic duct and the ventral cloaca. This canal becomes progressively obliterated after birth. It uncommonly persists to different degrees after birth.
CASE DESCRIPTION
A young bull was presented with distended abdomen and clinical signs of chocking, with low-grade fever, loss of appetite, frothy mouth arched back. On the first inspection, the animal was suspected to have simple indigestion. The treatment was attempted in this stage by introducing a stomach tube but only little relief was achieved. Therefore, 5 days later, an exploratory laparotomy was done and a big balloon-like cyst structure extended ventro-latrally in the abdominal cavity was noticed. That structure was located on the floor of the abdominal cavity extending from the pelvic rim caudally to the umbilical region cranially. The structure was then incised and evacuated and a rubber tube was fixed for constant drainage for up to one month later. The bull was followed-up and made a good recovery after a month post-surgery.
CONCLUSION
We found that urachal abscess could be treated simply via surgical evacuation of the abscess and proper drainage for some time with a very promising outcome. Additionally, this affection can be diagnosed based on history, clinical signs, and exploratory surgery, when relatively modern diagnostic techniques are not available.
Topics: Male; Animals; Cattle; Abscess; Urachal Cyst; Conservative Treatment; Urachus; Diagnosis, Differential; Cattle Diseases
PubMed: 36589410
DOI: 10.5455/OVJ.2022.v12.i5.6 -
Anales Del Sistema Sanitario de Navarra Dec 2022Among the causes of acute surgical abdomen, infection of a urachal remnant may go unnoticed despite routine complementary studies. We present three cases in boys aged...
Among the causes of acute surgical abdomen, infection of a urachal remnant may go unnoticed despite routine complementary studies. We present three cases in boys aged 11, 6, and 4 years who were brought to the emergency department for right iliac fossa pain, fever, and urinary symptoms. Examination and complementary tests results were compatible with acute complicated appendicitis and were sent to surgery. While in the operating room, appendicitis was excluded and inflammatory changes suggestive of infection of the urachal remnant were documented. Complications of urachal remnants should be considered in the differential diagnosis of acute surgical abdomen, since advanced infection of the urachus may be a cause of confusion. A more accurate presumptive diagnosis can change the therapeutic/surgical approach and follow-up.
Topics: Male; Humans; Abdomen, Acute; Urachal Cyst; Appendicitis; Urachus; Diagnosis, Differential
PubMed: 36576388
DOI: 10.23938/ASSN.1026 -
Diagnostics (Basel, Switzerland) Dec 2022The urachus is an embryologic remnant of the cloaca that usually degenerates after birth, resulting from the obliteration of the allantois, whose role is to connect the...
The urachus is an embryologic remnant of the cloaca that usually degenerates after birth, resulting from the obliteration of the allantois, whose role is to connect the bladder to the umbilicus. Incomplete removal of the lumen may give rise to different malformations of the median umbilical ligament after birth. Although in the pediatric population urachus are common, most cases are asymptomatic and may go unrecognized until adulthood and give rise to cysts, rarely reported in the literature. Thus, in this manuscript we present the circumstances of a 43-year-old Romanian woman showing hypogastric pain of moderate intensity for three weeks, radiation in the left lower limb, menstrual cycle abnormalities, and dysmenorrhea. Based on the initial examinations, a paraovarian cyst measuring 80 mm was noted. Through the subsequent magnetic resonance imaging (MRI) conducted, a hypoechoic mass was detected, and the patient underwent a tumorectomy and partial cystectomy. A 9.7/7.5-cm tumor was excised, and the anatomopathological result was urachal mucinous cystadenoma. It came to our attention that relatively scarce data were found in the literature, with only seven studies with the diagnosis of the urachal cyst.
PubMed: 36553173
DOI: 10.3390/diagnostics12123166 -
World Journal of Pediatric Surgery 2022
PubMed: 36474743
DOI: 10.1136/wjps-2022-000429 -
Urology Feb 2023
Topics: Humans; Urachus; Urachal Cyst
PubMed: 36473590
DOI: 10.1016/j.urology.2022.11.023 -
Aktuelle Urologie Sep 2023This case presents a 29-year-old man, with a urinary diversion via MAINZ Pouch I after cystectomy due to trauma in early childhood with a history of multiple previous...
This case presents a 29-year-old man, with a urinary diversion via MAINZ Pouch I after cystectomy due to trauma in early childhood with a history of multiple previous surgeries. The reason for the presentation was a non-specific paraumbilical swelling on the right, which was disturbing for him. Despite further diagnostics by means of magnetic resonance imaging, a clear diagnosis of the subcutaneous tissue could not be made. After surgical removal of the complete cyst and after histological work-up, the diagnosis of an urachus-cyst could be made.
Topics: Humans; Male; Child, Preschool; Adult; Appendix; Urachal Cyst; Urinary Reservoirs, Continent; Urinary Diversion; Cystectomy; Cysts
PubMed: 36473484
DOI: 10.1055/a-1909-5871 -
International Journal of Surgery Case... Dec 2022Urachal cyst (UC) sinus occur secondary failed regression of allantois's embryonal canal during fetal development. Several types depending on the arrest level and...
INTRODUCTION AND IMPORTANCE
Urachal cyst (UC) sinus occur secondary failed regression of allantois's embryonal canal during fetal development. Several types depending on the arrest level and connection to the urogenital tract. Umbilical urachal sinus is characterized in less than 15 % of cases. An infected urachal sinus patient can present with umbilical sinus and purulent discharge with various emergency presentations and scenarios.
CASE PRESENTATION
A 26-year-old Sudanese male, a healthy athlete, presented two weeks before the last presentation with periumbilical discomfort, and umbilical discharge increased with physical activity. He was first seen in the outpatient clinic and diagnosed with an uncomplicated umbilical cyst. One week later, periumbilical pain became throbbing, severe with a dragging sensation, and skin erythema. His swelling produced purulent discharge with concomitant low-grade fever. He denied any past medical, surgical, or family history. An ultrasound scan revealed a periumbilical cyst confirmed by CECT consistent with an infected urachal sinus. Surgical excision of the cyst and umbilicoplasty was achieved with an uneventful postoperative course.
CLINICAL DISCUSSION
Urachal sinuses may vary in their presentation according to the anomaly and clinical effect. It can be daunting to diagnose, even with the availability of CECT modalities. Conservative management can be of benefit in case of incidental findings, but surgical management is the preferred approach for complicated patients. A laparoscopic approach is the recommended treatment.
CONCLUSION
Our case report shows that serious complications can be prevented with early diagnosis, management, and prompt surgical intervention if this rare diagnosis is kept in mind.
PubMed: 36436421
DOI: 10.1016/j.ijscr.2022.107784 -
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