Current diagnosis and management of urachal remnants

“…Common complications associated with urachal remnants include pain, urinary infection, urachal abscess and stone formation. Cases of spontaneous perforation of urachal diverticulum or cysts [8,9], diverticular tumors [10], urachal-sigmoid fistula [11], cholecysto-urachal fistula [12] and injury during laparoscopy have been described.…”

Section: Urachal Abnormalitiesmentioning

confidence: 99%

Injury to Urachal Diverticulum Due to Laparoscopy Port: A Case Report, Literature Review and Recommendations

Kumar¹,

Mehanna²

2015

J Med Cases

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Minimally invasive surgery has gained widespread acceptance in elective and emergency situations due to reduced pain, length of hospital stay for patients and wider view of the operative field. However, it does bring its own set of specific risks and complications that must be kept in mind. Injury to the urinary bladder, in particular in the setting of an undiagnosed urachal abnormality can easily go unrecognized at the time of operation. Injury to an unsuspected urachal diverticulum due to laparoscopic port placement is an extremely rare complication due to the very low incidence of this abnormality. We report a case of a 10-year-old boy who sustained an injury to an urachal diverticulum during a routine laparoscopic appendicectomy and give recommendations to minimize the risk of injury to the urinary bladder or an associated urachal diverticulum.

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“…Urachal cysts or sinuses may be complicated by recurrent urinary tract infections or calculi and urachal remnants may undergo malignant transformation. In the pediatric population, symptomatic urachal remnants may be treated surgically or expectantly, with a large proportion of urachal remnants resolving spontaneously [4,36]. Due to the risk of malignancy in urachal remnants which persist to adulthood, surgical resection may be considered [37].…”

Section: Urachal Anomaliesmentioning

confidence: 99%

Suburothelial and extrinsic lesions of the urinary bladder: radiologic and pathologic features with emphasis on MR imaging

et al. 2015

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Compared to the more common urothelial lesions, at cystoscopy, suburothelial and extrinsic diseases of the urinary bladder wall often have a non-specific appearance or may be occult. Cross-sectional imaging, in particular MRI, plays an integral role in diagnosis. Mesenchymal tumors have distinct imaging features on MRI. Leiomyomas are characteristically low signal intensity on T2-weighted (T2W) imaging and progressively enhance. Lipomas and lipomatous hypertrophy are diagnosed by the presence of macroscopic fat. Neurofibromas, hemangiomas, and paragangliomas are hyperintense on T2W sequences and hypervascular. Reactive lesions occur in the setting of chronic inflammation and include: nephrogenic adenoma, cystitis cystica, and cystitis glandularis. Imaging findings are commonly non-specific; however, a mass with internal cystic spaces in association with pelvic lipomatosis is suggestive of cystitis glandularis. Urachal anomalies may be complicated by infection or malignancy. Urachal mucinous adenocarcinoma has a poor prognosis and may present as a T2-hyperintense suburothelial/extrinsic mass centered in the bladder dome. Other diseases may extrinsically involve the urinary bladder by hematogenous and peritoneal spread, including infection, endometriosis, and malignancy. A familiarity with suburothelial and extrinsic pathologies of the urinary bladder is critical for the radiologist, who may be the first to suggest these diagnoses.

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Current diagnosis and management of urachal remnants

Cited by 109 publications

References 8 publications

Trends in surgical management of urachal anomalies

Trends in surgical management of urachal anomalies

Injury to Urachal Diverticulum Due to Laparoscopy Port: A Case Report, Literature Review and Recommendations

Suburothelial and extrinsic lesions of the urinary bladder: radiologic and pathologic features with emphasis on MR imaging

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