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Journal of Minimal Access Surgery 2023To report our experience in the laparoscopic management of symptomatic urachal remnants (URs) in adults.
AIM
To report our experience in the laparoscopic management of symptomatic urachal remnants (URs) in adults.
PATIENTS AND METHODS
A retrospective study included all patients who underwent laparoscopic excision of URs during the period January 2015-January 2020. The following data were retrieved from the files of the patients: demographic data, clinical presentations, intra-operative findings, the procedure performed, operative details, intraoperative or post-operative complications and follow-up period mentioned in the files for those patients.
RESULTS
The study included 10 patients (four males and six females) with a mean age of 27.8 ± 11.0 years. URs were discovered preoperatively in all patients except one patient who was diagnosed intraoperatively. URs were associated with other pathologies in four patients (40%) that required two simultaneous surgical procedures. Eight patients (80%) presented with simple umbilical discharge and were diagnosed easily by ultrasonography. All patients were managed successfully with laparoscopic excision and umbilical sparing technique. Excision of the dome of the bladder was done on the selective approach to one patient. No patients showed early post-operative complications. Only one patient had stitch sinus 6 months postoperatively due to a concomitant hernia repair rather than due to the excision of the URs.
CONCLUSIONS
Laparoscopic excision of symptomatic urachus is a feasible procedure even when the excision of the bladder is required. It could be performed successfully with other pathologies. It is associated with a low incidence of complications. Laparoscopy allows good visualisation and complete excision that leads to almost no recurrence rate.
PubMed: 37056087
DOI: 10.4103/jmas.jmas_72_22 -
The New England Journal of Medicine Feb 2023
Topics: Humans; Peritoneal Diseases; Urachus; Urethra; Urinary Bladder Diseases; Urinary Tract; Umbilicus
PubMed: 36807403
DOI: 10.1056/NEJMicm2204739 -
Journal of Medical Case Reports Jan 2023Giant umbilical cord, defined as a cord diameter of more than 5 cm, is an extremely rare malformation. There are few case reports of giant umbilical cord often... (Review)
Review
BACKGROUND
Giant umbilical cord, defined as a cord diameter of more than 5 cm, is an extremely rare malformation. There are few case reports of giant umbilical cord often associated with patent urachus duct or cystic malformation. These cases are usually managed by surgical excision and repair of patent urachus or cyst resection.
CASE PRESENTATION
We report the case of a 1-day-old Iranian boy with giant umbilical cord detected postnatally. The pregnancy course was uneventful, except for preterm premature rupture of the membrane and preterm delivery. There was no relevant family history. The patient was delivered by vaginal delivery with a good Apgar score. On clinical examination, the umbilical cord was very thick (about 6 cm in diameter), and huge fluctuating Wharton's jelly was observed. Other organs were normal. During the hospital stay, the patient did not develop any complications except borderline hyperbilirubinemia, which improved with conventional phototherapy. Since the umbilical cord had no discharge and was dried, the newborn was discharged with advice for cord drying care.
CONCLUSION
The newborn was well, and the dried umbilical stump was detached after 32 days, leaving a granulomatous structure without discharge. The patient was followed up for 4.5 months and had no problems except delayed separation of the umbilical cord.
Topics: Male; Pregnancy; Female; Humans; Infant, Newborn; Urachus; Iran; Ultrasonography, Prenatal; Infant, Premature; Umbilical Cord
PubMed: 36641443
DOI: 10.1186/s13256-022-03747-3 -
Journal of Veterinary Diagnostic... Mar 2023Hepatic ciliated foregut remnants or cysts are congenital abnormalities resulting from retention of embryonic ciliated foregut within the liver. These structures are...
Hepatic ciliated foregut remnants or cysts are congenital abnormalities resulting from retention of embryonic ciliated foregut within the liver. These structures are rarely reported in the human medical literature and have not been reported in the veterinary literature previously, to our knowledge. We describe here a case of an 8-wk-old male French Bulldog with a congenital patent hepatic ciliated foregut remnant resulting in an umbilicobiliary sinus tract. The dog also had concurrent gallbladder agenesis. The patient had yellow fluid discharging from the umbilicus, mimicking a patent urachus. Surgical exploration, removal, and histology provided a conclusive diagnosis of a hepatic foregut remnant and therapeutic resolution of the clinical signs. The histologic appearance of a hepatic foregut remnant is classical, namely a duct composed of 4 layers: an inner ciliated epithelial lining, loose connective tissue, smooth muscle, and a fibrous capsule.
Topics: Animals; Dogs; Male; Cilia; Dog Diseases; Gallbladder; Inflammation; Liver Diseases
PubMed: 36600481
DOI: 10.1177/10406387221147317 -
Annals of Medicine and Surgery (2012) Dec 2022and importance: Foetal hydrocolpos and anorectal malformation are difficult to diagnose prenatally due to abundance of differential diagnoses. This case report presents...
INTRODUCTION
and importance: Foetal hydrocolpos and anorectal malformation are difficult to diagnose prenatally due to abundance of differential diagnoses. This case report presents the challenges of diagnosing such disorders.
CASE PRESENTATION
A G3P2A0 woman came at 32 weeks of pregnancy with a referral for foetal ovarian cyst. Ultrasound revealed a singleton breech pregnancy, estimated foetal weight 3528 g. A septate abdominal cyst measuring 11.31 × 7.17 cm and polyhydramnios were present. Elective caesarean section delivered a female baby weighing 2820 g and measuring 43 cm. Neonatal examination revealed a right lateral suprapubic mass and a rectovestibular fistula. A sinoscopy revealed a suspected hydrocolpos. An abdominal hydrocolpos drainage was performed; a patent urachus and normal bilateral adnexa were present.
CLINICAL DISCUSSION
Hydrocolpos is a rare congenital disorder due to distal obstruction of various etiologies. It may be mistaken with other pathologies, including fetal ovarian cysts. A genitourinary congenital abnormality may occur in conjunction with other abnormalities, including gastrointestinal tract anomalies. The presence of imperforate anus and/or fistula should alert the clinician of a possible association with VACTERL syndrome.
CONCLUSION
Hydrocolpos is a rare congenital genitourinary disorder with various differential diagnoses. Simultaneous presence of other abnormalities is likely, with possible association to other syndromes.
PubMed: 36582906
DOI: 10.1016/j.amsu.2022.104949 -
Khirurgiia 2022A patient with external-internal sigmoid-vesical fistula is presented. The authors describe surgical intervention (urachus excision, removal of infiltrate with resection...
A patient with external-internal sigmoid-vesical fistula is presented. The authors describe surgical intervention (urachus excision, removal of infiltrate with resection of bladder bottom and fistula-related segment of sigmoid). Surgical challenges due to localization of fistula and appropriate literature data are discussed.
Topics: Humans; Urinary Bladder Fistula; Urinary Bladder; Urachus; Intestinal Fistula; Colon, Sigmoid; Gastrointestinal Diseases; Diverticulum
PubMed: 36562676
DOI: 10.17116/hirurgia202212273 -
Journal of Obstetrics and Gynaecology... Dec 2022
PubMed: 36457447
DOI: 10.1007/s13224-021-01577-9 -
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 -
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