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Urachus
Aka: Urachus, Urachal Anomaly, Urachal Vestige, Patent Urachus, Urachal Cyst, Urachal Sinus, Vesicourachal Diverticulum
- Physiology
- Urachus develops from Urogenital sinus
- Superior portion develops into Bladder and Urachus
- Inferior portion develops into Urethra
- Urachus obliterates during month 4-5 of gestation
- Urachus left as fibrous cord remnant
- Cord stretches from Bladder to Umbilicus
- Signs
- Persistent drainage from newborn Umbilicus
- Delayed separation of Umbilical Cord
- Omphalitis
- Causes: Urachal Anomaly (Urachus not fully obliterated)
- Patent Urachus (50%)
- Results from complete lack of urachal involution
- Free communication from Bladder to Umbilicus
- Urachal Cyst (30%)
- Cyst of desquamated epithelial cells
- Small and undetected in two thirds of cases
- Risk of urachal abscess with secondary peritonitis
- Urachal Sinus
- Communication with Umbilicus
- Vesicourachal Diverticulum (Bladder Diverticulum)
- Radiology: Urachal Anomaly Detection
- CT Abdomen (best evaluation)
- Abdominal Ultrasound
- Voiding Cystourethrogram (if umbilical discharge)
- References
- Hollinshead (1985) Anatomy, Harper and Row, p. 756
- Lotan (2002) Am Fam Physician 65(10):2067-8 [PubMed]
- Razvi (2001) Pediatrics 108(2):493-4 [PubMed]