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International Journal of Surgery Case... 2018A fistula involving a patent urachus in a patient with Crohn's disease is rare. Here we report ileourachal fistula formation in two patients with Crohn' disease.
INTRODUCTION
A fistula involving a patent urachus in a patient with Crohn's disease is rare. Here we report ileourachal fistula formation in two patients with Crohn' disease.
CASE PRESENTATIONS
The first patient was a 29-year-old man with Crohn's disease and ileitis, and the second patient was a 43-year-old man with Crohn's disease and ileitis. One of the patients showed pus/fecal discharge via the umbilicus. Both patients were eventually diagnosed with an ileourachal fistula associated with Crohn's disease. In the first patient, the urachal remnant was connected to the urinary bladder and a Crohn's disease-related intestinal lesion had formed a fistula to the urachus. In the second patient, a periumbilical inflammatory lesion extended to the bladder through the urachal remnant and to a longitudinal ulcer of the ileal lesion. The first patients underwent partial ileal resection, and partial cystectomy, while the second patient underwent urachal curettage, partial ileal resection, and partial cystectomy. In both.
CONCLUSION
In cases of Crohn's disease with an enterocutaneous fistula or pus discharge via the umbilicus, an examination to detect an urachal remnant with a fistula from the diseased intestine should be performed.
PubMed: 30390487
DOI: 10.1016/j.ijscr.2018.10.031 -
Journal of the American Veterinary... Oct 2004
Topics: Animals; Animals, Newborn; Diagnosis, Differential; Dogs; Enrofloxacin; Fluoroquinolones; Male; Quinolones; Radiography; Ultrasonography; Urachus; Urinalysis
PubMed: 15515981
DOI: 10.2460/javma.2004.225.1041 -
Case Reports in Surgery 2016. A patent urachus is a rare congenital or acquired pathology, which can lead to complications later in life. We describe a case of urachal cystitis as the etiology of...
. A patent urachus is a rare congenital or acquired pathology, which can lead to complications later in life. We describe a case of urachal cystitis as the etiology of small bowel obstruction in an adult without prior intra-abdominal surgery. . A 64-year-old male presented to the acute care surgery team with a 5-day history of right lower quadrant abdominal pain, distention, nausea, and vomiting. He had a two-month history of urinary retention and his past medical history was significant for benign prostate hyperplasia. On exam, he had evidence of small bowel obstruction. Computed tomography revealed high-grade small bowel obstruction secondary to presumed ruptured appendicitis. In the operating room, an infected urachal cyst was identified with adhesions to the proximal ileum. After lysis of adhesions and resection of the cyst, the patient was subsequently discharged without further issues. . Although rare, urachal pathology should be considered in the differential diagnosis when evaluating a patient with small bowel obstruction without prior intraabdominal surgery, hernia, or malignancy.
PubMed: 27900227
DOI: 10.1155/2016/3247087 -
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 -
Central European Journal of Urology 2014The urachus is the remnant of the cloaca, which in adults attaches the bladder dome to the umbilicus. After birth it obliterates and presents as the midline umbilical...
The urachus is the remnant of the cloaca, which in adults attaches the bladder dome to the umbilicus. After birth it obliterates and presents as the midline umbilical ligament. Patent urachal anomalies are usually detected in childhood. In adults they occur very rarely and the presentation and diagnosis may be occasionally challenging. We present and discuss the case of an infected urachal cyst found in a 30-year-old adult.
PubMed: 25140240
DOI: 10.5173/ceju.2014.02.art19 -
Schweizer Archiv Fur Tierheilkunde Nov 2009This case report describes the clinical, ultrasonographic and cystoscopic findings and treatment in a two-year-old Swiss Braunvieh heifer with rupture of a patent...
This case report describes the clinical, ultrasonographic and cystoscopic findings and treatment in a two-year-old Swiss Braunvieh heifer with rupture of a patent urachus. The lead signs in the seven-month-pregnant heifer were markedly abnormal general condition and demeanour and a pear-shaped abdomen. The heifer had severe azotaemia, and abdominal ultrasonography revealed ascites, which was diagnosed as uroperitoneum based on an elevated creatinine level in the fluid. A patent urachus was identified during cystoscopy; the endoscope could be advanced beyond the apex of the urinary bladder into the urachus. Based on all the findings, a diagnosis of uroperitoneum attributable to rupture of a patent urachus was made. The urachus was ligated twice via a left-flank laparotomy. The general condition normalised within a few days of surgery, and the patient calved normally and was in good health at follow-up evaluation.
Topics: Animals; Ascites; Cattle; Cattle Diseases; Cystoscopy; Female; Pregnancy; Pregnancy, Animal; Ultrasonography, Prenatal; Urachus
PubMed: 19885799
DOI: 10.1024/0036-7281.151.11.539 -
Polish Journal of Radiology 2014Gastrointestinal tract duplication is a rare malformation associated with the presence of additional segment of the fetal gut. The aim of this study was to...
BACKGROUND
Gastrointestinal tract duplication is a rare malformation associated with the presence of additional segment of the fetal gut. The aim of this study was to retrospectively review clinical features and imaging findings in intraoperatively confirmed cases of gastrointestinal tract duplication in children.
MATERIAL/METHODS
The analysis included own material from the years 2002-2012. The analyzed group included 14 children, among them 8 boys and 6 girls. The youngest patient was diagnosed at the age of three weeks, and the oldest at 12 years of age.
RESULTS
The duplication cysts were identified in the esophagus (n=2), stomach (n=5), duodenum (n=1), terminal ileum (n=5), and rectum (n=1). In four cases, the duplication coexisted with other anomalies, such as patent urachus, Meckel's diverticulum, mesenteric cyst, and accessory pancreas. Clinical manifestation of gastrointestinal duplication cysts was variable, and some of them were detected accidently. Thin- or thick-walled cystic structures adjacent to the wall of neighboring gastrointestinal segment were documented on diagnostic imaging.
CONCLUSIONS
Ultrasound and computed tomography are the methods of choice in the evaluation of gastrointestinal duplication cysts. Apart from the diagnosis of the duplication cyst, an important issue is the detection of concomitant developmental pathologies, including pancreatic heterotopy.
PubMed: 25114725
DOI: 10.12659/PJR.890443 -
Chang Gung Medical Journal Jun 2003The embryological and anatomical features of urachal anomalies have been well defined. Because of the variable clinical presentations, uniform guidelines for evaluation...
BACKGROUND
The embryological and anatomical features of urachal anomalies have been well defined. Because of the variable clinical presentations, uniform guidelines for evaluation and treatment are lacking. In an attempt to establish an optimal diagnostic and treatment modality, we report our experience with urachal anomalies at a single institution over a 10-year period.
METHODS
The records of 20 patients with urachal abnormalities were reviewed. These included 12 males and 8 females with ages from 1 day to 12 years (average, 3 years). The evaluation included symptoms and signs, and results of fistulography, sonography, and voiding cystography. Postoperative conditions were also reviewed.
RESULTS
The presenting complaint was umbilical discharge in 14 patients, umbilical discharge with marked umbilical granulation tissue in 2, periumbilical erythema in 3, and abdominal pain in 1. Diagnostic evaluation included fistulography in 5 cases, sonography in 13, and voiding cystourethrography in 3. The 3 variants of urachal anomalies included a patent urachus in 4 patients (20%), urachal sinus in 13 (65%), and an infected urachal cyst in 3 (15%). Treatment consisted of primary excision with a cuff of the bladder in 3, excision with ligation in 1, excision of the sinus in 13, incision and drainage in 3, and secondary excision in 1. There was 1 postoperative wound infection.
CONCLUSION
Diagnosis and treatment of urachal anomalies can be made with certainty if a good physical examination and proper imaging study are performed. Voiding urethrocystography might not be required in view of the fact that none of the patients studied had an associated urinary tract anomaly.
Topics: Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Male; Urachus
PubMed: 12956287
DOI: No ID Found -
British Medical Journal Oct 1875
PubMed: 20747989
DOI: 10.1136/bmj.2.772.486 -
Korean Journal of Urology May 2010In this study, we report our initial experience with robot-assisted laparoscopic partial cystectomy (RLPC) in urachal diseases.
PURPOSE
In this study, we report our initial experience with robot-assisted laparoscopic partial cystectomy (RLPC) in urachal diseases.
MATERIALS AND METHODS
Two men and two women with a mean age of 51.5+/-9.3 years underwent RLPC between June 2009 and December 2009. In each case, a single surgeon using the da Vinci-S robotic system (Intuitive Surgical, Sunnyvale, CA, USA) used a transperitoneal approach with a 0 degrees robotic camera. After careful observation of the intravesical portion of the mass, the mass was excised by use of monopolar scissors circumferentially. The bladder was closed in two layers with watertight running sutures made with 2-0 Vicryl.
RESULTS
The mean operative time was 198 minutes (range, 130-260 minutes), the mean console time was 111 minutes (range, 70-150 minutes), and the mean estimated blood loss was 155 ml. The urethral catheter was removed on postoperative day 7 after a normal cystogram, and the surgical drain was removed on postoperative day 2.5 (range, 2-3 days). The mean hospital stay was 6 days (range, 4-7 days). There were no major complications. The pathology report revealed that one patient had a urachal cystadenoma, two patients had a urachal cyst, and one patient had a patent urachus.
CONCLUSIONS
Our initial experience with RLPC for benign urachal disease is that it is a safe and feasible treatment modality. However, more cases are required to confirm the efficacy of RLPC.
PubMed: 20495694
DOI: 10.4111/kju.2010.51.5.318