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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 -
Urology Case Reports Nov 2022Urachal cancer is a rare but aggressive malignancy. A urachal mass concerning for adenocarcinoma was identified in a 32-year-old G2P1 female on 12-week ultrasound and...
Urachal cancer is a rare but aggressive malignancy. A urachal mass concerning for adenocarcinoma was identified in a 32-year-old G2P1 female on 12-week ultrasound and confirmed on pelvic MRI. Due to progressive growth of the mass and refractory abdominal pain, a multi-disciplinary meeting was held, after which the patient chose to undergo an exploratory laparotomy. A tubo-ovarian abscess was identified involving the intestine, right ovary, fallopian tube, and communicating with a patent, necrotic urachus. This is the first reported case of a tubo-ovarian abscess masquerading as a urachal malignancy, which can present similarly with abdominal pain and irritative urinary symptoms.
PubMed: 36033164
DOI: 10.1016/j.eucr.2022.102191 -
Pediatric Surgery International Nov 2022It has been suggested that symptomatic UA requires surgical excision. However, the management of asymptomatic urachus is still controversial. We aimed to evaluate the...
PURPOSE
It has been suggested that symptomatic UA requires surgical excision. However, the management of asymptomatic urachus is still controversial. We aimed to evaluate the clinical presentation, the efficacy of current modalities used, and postoperative pathology in patients with UA.
MATERIALS AND METHODS
We have performed a retrospective review of all patients diagnosed with UA and treated surgically or conservatively over 18 years. Demographic data, clinical presentation, imaging modalities, pathology, treatment, and postoperative complications were analyzed.
RESULTS
Twenty-five symptomatic patients (18 males and seven females) with a median age of 13 years (1 month to 37 years) were identified. 15 (60%) were diagnosed with a urachal cyst, 4 (16%) with sinus, 3 (12%) with urachal diverticulum, and the remaining 3 (12%) with patent urachus. Of those, 20 (80%) underwent surgical repair, and the remaining five (20%) patients were managed conservatively. 4 (20%) underwent laparotomy, 7 (35%) laparoscopic incision, and the remaining 9 (45%) laparoscopic robotic-assisted surgery. Nine patients required bladder cuff excision. The median operative time was 75 min (42-140 min). One patient developed Clavien-Dindo grade IIIA complication resulting in infected hematoma, which resolved after drainage. Another patient with a complication of grade IIIB needed reoperation as a result of recurrent events of an abscess. 13 (65%) demonstrated epithelium lining of the urachus on postoperative pathology.
CONCLUSIONS
Our data show that most of the patients with UA presented with epithelial lining, which might lead to the later malignant transformation. It might cause a shift from the conservative management of asymptomatic patients to surgical intervention. Robotic-assisted surgery appears beneficial in these patients, especially when the bladder cuff excision is required.
Topics: Adolescent; Female; Humans; Laparoscopy; Male; Retrospective Studies; Robotic Surgical Procedures; Urachal Cyst; Urachus
PubMed: 35969254
DOI: 10.1007/s00383-022-05194-z -
Pediatrics and Neonatology Jul 2022
Topics: Cysts; Female; Gastrointestinal Diseases; Humans; Pregnancy; Ultrasonography, Prenatal; Umbilical Cord; Umbilicus; Urachus
PubMed: 35637080
DOI: 10.1016/j.pedneo.2022.04.003 -
Medicine May 2022A patent urachus is a rare congenital anomaly that atypically presents as an umbilical cord cyst or large umbilical cord. Here we describe a case of a giant umbilical...
RATIONALE
A patent urachus is a rare congenital anomaly that atypically presents as an umbilical cord cyst or large umbilical cord. Here we describe a case of a giant umbilical cord cyst in a newborn diagnosed as a patent urachus.
PATIENT CONCERNS
A male infant with a birth weight of 3260 g was transferred because of an antenatally diagnosed giant umbilical cord cyst accompanied by yellowish discharge and granulation in the umbilical cord after birth.
DIAGNOSES
Patent urachus.
INTERVENSIONS
The patent urachus was treated by excision of the urachal remnant followed by partial cystectomy.
OUTCOMES
Postoperative orchitis with pyocele occurred and was treated with a course of antimicrobial therapy; and no other complications developed.
LESSONS
Newborns with a giant umbilical cord or umbilical cord cysts should be examined for possible accompanying urachal anomalies, even if antenatal ultrasound shows no other suspicious findings, to prevent delayed diagnosis and subsequent complications.
Topics: Communicable Diseases; Cysts; Female; Humans; Infant; Infant, Newborn; Male; Musculoskeletal Diseases; Pregnancy; Ultrasonography, Prenatal; Umbilical Cord; Urachus; Urinary Bladder
PubMed: 35608419
DOI: 10.1097/MD.0000000000029187 -
Urology Case Reports Jul 2022Ingestion of foreign body may induce complications such as perforation, impaction, or penetration. Diagnosis rarely made preoperatively due to clinical symptoms are...
Ingestion of foreign body may induce complications such as perforation, impaction, or penetration. Diagnosis rarely made preoperatively due to clinical symptoms are usually nonspecific and can mimic other surgical conditions. A 69-year-old male presented to emergency department with vague abdominal pain for few days. Following a clinical evaluation and computed tomography scan of the abdomen, provisional diagnosis of urachal carcinoma was made. As the result of urachal excision with partial cystectomy including fishbone were resected, pathology revealed benign urothelium.
PubMed: 35573084
DOI: 10.1016/j.eucr.2022.102102 -
Pediatrics and Neonatology Jul 2022
Topics: Cysts; Female; Gastrointestinal Diseases; Humans; Pregnancy; Ultrasonography, Prenatal; Umbilical Cord; Umbilicus; Urachus
PubMed: 35550350
DOI: 10.1016/j.pedneo.2022.03.008 -
BMJ Case Reports Apr 2022Vitellointestinal duct anomalies, although one of the most frequent malformations to be found (2%-3% in population), they are most unlikely to cause symptoms. A...
Vitellointestinal duct anomalies, although one of the most frequent malformations to be found (2%-3% in population), they are most unlikely to cause symptoms. A persistent Vitellointestinal duct can induce abdominal pain, bowel obstruction, intestinal haemorrhage and umbilical sinus, fistula or hernia which commonly occurs in children. Patent vitellointestinal duct or persistent omphalomesenteric duct is a very unusual congenital anomaly which occurs in 2% of the population related to the embryonic yolk stalk. Similarly, urachal anomalies remain a rare finding, with the most common being a cyst or sinus followed by patent urachus and rarely a urachal diverticulum. Presenting symptoms include periumbilical discharge, pain and a palpable mass.Here, we report a case of an adult patient with patent vitellointestinal duct and urachus identified intraoperatively on diagnostic laparoscopy when being operated for umbilical hernia repair.
Topics: Adult; Child; Hernia, Umbilical; Humans; Intestinal Obstruction; Meckel Diverticulum; Urachus; Vitelline Duct
PubMed: 35365469
DOI: 10.1136/bcr-2021-247789 -
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 -
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