The current strategy for urachal remnants

Satō, Hideaki; Furuta, Shigeyuki; Tsuji, Shiho; Kawase, Hirokazu; Kitagawa, Hiroaki

doi:10.1007/s00383-015-3712-1

Cited by 36 publications

(39 citation statements)

References 18 publications

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“…10 According to Sato et al, the most common symptom is umbilical granulation in infants and abdominal pain in older children. 11 It has been reported that malignancy may develop in later years. 12 Infected urachal cysts rarely rupture and can rapidly become symptomatic.…”

Section: Discussionmentioning

confidence: 99%

Evaluation and management of urachal remnants in children

Orbatu

Alaygut

2020

Pediatrics International

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Background: This study aimed to evaluate the diagnosis and treatment of pediatric patients with urachal remnants. Methods: Medical records of patients diagnosed with urachal remnants between 2015-2019 were evaluated retrospectively. Age, gender, admission complaints, diagnosis, size of cysts, the complications that developed, and treatment modalities were recorded. Results: The study population consisted of 15 cases including seven girls. Most of the cases were asymptomatic. The urachal remnants were detected by ultrasonography. The most common symptom in symptomatic patients was abdominal pain and umbilical discharge. Three patients required surgery and most of them were conservatively followed up. Complication, infection, and bladder rupture were observed in one case. Conclusions: Follow-up of patients with urachal remnants can be performed conservatively. The type of complaint and the presence of clinical and radiological regression (if any) are important for deciding the treatment during the follow-up. However, conservative follow-up is more prominent today, as shown in this study.

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Section: Discussionmentioning

confidence: 99%

Evaluation and management of urachal remnants in children

Orbatu

Alaygut

2020

Pediatrics International

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“…UAs can be diagnosed by US. Two studies reported 12 and 27 cases of UA, in which all of their patients were diagnosed by US with limited usage of CT scans and magnetic resonance imaging (MRI) which were only used for further detailed anatomy [14,15]. However, Widni et al reported US as having 79% sensitivity, 30% specificity, and 83% positive predictive value in diagnosing UAs [16].…”

Section: Discussionmentioning

confidence: 99%

“…Complete surgical excision is considered the treatment of choice, given the risk of malignant transformation and the high recurrence rate after simple drainage, which Mesrobian et al reported at 39% [17]. The excision can be done either by an open laparoscopic approach [14,15] or a robotic assisted laparoscopic surgery [18]. Bertozzi et al reported 12 cases of UA that were treated by laparoscopic or laparoscopic-assisted surgery [14].…”

Section: Discussionmentioning

confidence: 99%

Urachal abscess in a child with single kidney and multiple anomalous vertebrae—a case report and literature review

2020

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Background: Urachal anomalies (UAs) are rare in children; the most encountered are urachal cysts, urachal sinus, and urachal diverticulum. Other associated anomalies have been reported to include renal and abdominal wall defects. No skeletal anomalies have been reported to date. Case presentation: We present a case of a 20-month-old female patient, who presented to our emergency department with a fever of 2 weeks duration associated with colicky abdominal pain, a tender abdomen, and an infraumbilical mass. The suspicion of urachal sinus abscess was confirmed by ultrasound. The patient was also found to have a single left kidney and multiple vertebral segmental anomalies on a full-body computed tomography scan. The patient underwent open surgical excision of the urachal abscess without complications on follow-up. Conclusion: Urachal abscess is rare in children. Associated anomalies include renal and abdominal wall defects. To our knowledge and based on our meticulous search through the literature, this is the first case to report a combination of renal and skeletal findings in a child. Whenever a urachal remnant is found in a patient, a radiological investigation should be made to rule out associated anomalies.

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“…Although rare, malignant trans-formation may occur [2,14,17]. Other urachal anomalies are diagnosed in early childhood, needing surgery when bladder infections are recurrent [19].…”

Section: Discussionmentioning

confidence: 99%

Urachal Cyst in a Bitch

Hertel

Silva

Evangelista

et al. 2019

Acta Scientiae. Vet.

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Background:The urachus is a tubular structure continuous with the urinary bladder and the allantois in foetal mammals. It serves as a communication between these two structures. At birth, it loses its function and undergoes atrophy by fibrous proliferation within the lumen. When this atrophy process fails at some point, congenital anomalies of the urachus occur. These anomalies are rare in animals, and to our knowledge, the urachal cyst has not yet been described in dogs. The present work is unique in that it reports a case of this congenital defect in a dog. Our aim is to increase awareness and to discuss the clinical presentation, the imaging techniques used, and the final diagnosis of this anomaly. Case: A 3-year-old bitch Pit Bull was presented for veterinary assistance to investigate recurrent pseudopregnancy and an irregular estrous cycle. The animal presented in good bodily condition, and the white blood count and clinical biochemistry were normal. At ultrasound, 2 tubular structures, filled by an echogenic fluid mimicking uterine topography, were found extending through the umbilical and hypogastric regions. No alterations in structure, echogenicity or echotexture of the other organs were observed, including the ovaries and uterus. On exploratory laparotomy, a cystic structure was found, with 2 segments: the larger one was on the left side, attached to the apex of the bladder by its caudal portion; the other was on the right side, attached to the spleen by its cranial portion and to the apex of the bladder by its caudal portion in connection with the left segment. The ovaries, uterus and uterine horns showed no macroscopic alterations. The structure was removed, and after analysis (macroscopic morphology, wall histopathology and biochemistry of the contained fluid), it was determined to be a urachal cyst. The animal recovered uneventfully. Discussion: Ultrasound is an important tool for the evaluation of reproductive cycle physiology and its pathologies. At first, the owner's complaint justified a fairly straightforward evaluation and clinical management of pseudopregnancy in a very healthy animal based on the history and clinical and complementary exams. However, ultrasound examination revealed two tubular structures filled with echogenic fluid in the lower abdomen. This made the case more complex, as these were interpreted as uterine horns by three different veterinarians, leading to the possibility of pyometra. The management of this condition must be cautious, since the animal's condition could rapidly deteriorate, necessitating an exploratory laparotomy. Based on the clinical presentation, macroscopic anatomy, fluid biochemistry and histological evaluations, the diagnosis of urachal cyst was proposed. Congenital anomalies occur when the urachus fails to obliterate. Four types can be found: patent urachus, urachal sinus, urachal diverticulum and urachal cyst. The urachal cyst occurs when the urachus encompasses a cyst-like structure that is closed to the umbilicus and the bladder lumen. The urachus be...

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The current strategy for urachal remnants

Abstract: Conservative follow-up is recommended for UR under 1-year old except when there are repeated infections. The umbilical approach is enough for infants. Laparoscopic surgery is recommended in older children.

Cited by 36 publications

References 18 publications

Evaluation and management of urachal remnants in children

Evaluation and management of urachal remnants in children

Urachal abscess in a child with single kidney and multiple anomalous vertebrae—a case report and literature review

Urachal Cyst in a Bitch

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