Quiste de uraco infectado en edad infantil

Argente, V. Gimeno; Hinarejos, C. Domínguez; Durbá, A. Serrano; Moragues, F. Estornell; Verduch, M. Martínez; Ibarra, F. García

doi:10.4321/s0210-48062006001000011

Cited by 3 publications

(3 citation statements)

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“…Several authors suggest that systematic excision of urachal lesions which are detected during childhood should be performed in order to prevent infection or other problems in adulthood as the development of malignancy in residual remnants [2, 5, 7, 8], whereas others consider that conservative management, even in cases of infected anomalies [9, 10], results in better outcomes. For instance, Copp et al [11] state that surgery should only be performed in cases with unfavorable histology that is suggestive of malignancy, that is, cases with transitional epithelium, squamous metaplasia, intestinal metaplasia, or mixed metaplasia.…”

Section: Discussionmentioning

confidence: 99%

Urachal Pathology: Review of Cases

et al. 2021

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Introduction: The urachus is an embryologic remnant which is formed from the obliteration of the allantois. Urachal abnormalities are caused when defective obliteration of the urachus happens. They are an infrequent condition. Incidence is estimated to be between 5,000 and 8,000 live births. Its diagnosis and management remain a challenge due to the lack of an specific clinical picture and the controversy about the management. Objective: The objective of this study is to assess the clinical presentation, diagnosis, therapeutic management, and outcomes of urachal anomalies in our health area. Materials and Methods: We performed a retrospective review of all cases of urachal anomalies recorded Tenerife (southern health area), La Gomera, and El Hierro Islands during a 5 year period. Results: Twenty-three cases of urachal pathology were included. The mean age of presentation was 32 years old. 73.9% were male. 65% were diagnosed in adults. In 30.3% of the cases, it was a casual finding. Symptoms included fever, umbilical exudate, hematuria, abdominal pain, and umbilical granuloma. The main diagnostic tests were ultrasound and computed tomography scan. Treatments were selected conservative management (43.5%), selective resection, partial cystectomy, and radical cystectomy. All patients had a good evolution. However, 2 cases where benign tumors were suspected, clinically, had a final histology of cancer in the specimen. Conclusions: Due to the lack of a specific clinical picture and undefined findings in image tools, diagnosis is difficult and it may be inaccurate. Despite more data are needed, our results suggest that the systematic excision of urachal lesions could result in safer outcomes since cases where a benign lesion is clinically suspected might result in malignant tumors.

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Section: Discussionmentioning

confidence: 99%

Urachal Pathology: Review of Cases

et al. 2021

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“…Los quistes uracales suelen ser pequeños y asintomáticos hasta que debutan en forma de complicaciones 3 . Estas son infección, cálculos, sangrado, rotura, fístula al intestino, obstrucción intestinal y del tracto urinario, desarrollo de enfermedad de Reiter y malignización.…”

Section: Discussionunclassified

Ecografía en la consulta (n.º 1): quiste de uraco infectado, causa poco frecuente de dolor abdominal en Pediatría

Ortiz¹,

Ruiz

Muñoz

et al. 2014

Rev Pediatr Aten Primaria

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Ultrasound (n.º 1): infected urachal cyst, a rare cause of abdominal pain in pediatricsEl uraco es un remanente embriológico de la alantoides que puede dar lugar a diferentes anomalías, entre las que destaca el quiste de uraco. Se presenta el caso de un varón de cuatro años que consulta por dolor abdominal hipogástrico, fiebre y disuria. La tira reactiva de orina es normal; se realiza una ecografía abdominal que identifica en la región umbilical, inmediatamente por debajo de la pared abdominal y en dudosa comunicación con la vejiga, una imagen tubular lobulada que podría tratarse de un quiste de uraco complicado. Ingresa en el hospital para tratamiento antibiótico intravenoso y en un segundo tiempo se realiza la exéresis quirúrgica de la estructura anómala. El uraco es un remanente embriológico de la alantoides que se convierte en un cordón fibromuscular que se extiende desde la cúpula vesical hasta el ombligo. Si no hay una involución completa del uraco al nacer, puede dar lugar a diferentes anomalías, de las que el quiste uracal representa el 30%. Los quistes uracales suelen ser asintomáticos hasta que debutan en forma de complicaciones, siendo la infección la más frecuente. Para el diagnóstico es útil la ecografía. El tratamiento es antibiótico y el drenaje, y en un segundo tiempo la cirugía. Conviene considerar esta patología en el diagnóstico diferencial del niño con dolor abdominal y sintomatología miccional.The urachus is an embryological remnant of the allantois which may lead to different anomalies, and one of the most important is the urachal cyst. Case study: 4 year old male consults because of hypogastric abdominal pain, fever and dysuria. Normal urine dipstick, through abdominal ultrasound is identified a lobed tubular imaging in umbilical region immediately below the abdominal wall and probably in communication with the bladder that could be a complicated urachal cyst. Admitted to the hospital for intravenous antibiotic treatment and later a surgical excision of the anomalous structure is performed. The urachus is an embryological remnant of the allantois that becomes a fibromuscular cord extending from the bladder to the umbilicus. If there is not a complete regression of the urachus at birth may lead to different anomalies, among which the urachal cyst represents 30%. The urachal cysts are usually asymptomatic until the appearance of complications, and the infection is the most common. Is diagnosed usually by ultrasound and the treatment is antibiotics and drainage followed by excision of the urachal remnant. This condition should be considered in the differential diagnosis of children with abdominal pain and urinary symptoms.

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“…Durante el primer trimestre, el uraco juega un papel importante, ya que los desechos nitrogenados se eliminan por este a través del cordón umbilical hacia la placenta. Este se oblitera en la décimo octava semana de gestación secundario al descenso vesical, constituyendo un cordón fibromuscular conocido como el ligamento umbilical medio 3 . El ligamento umbilical medio no tiene función alguna, siendo solo un vestigio del uraco.…”

Section: Introductionunclassified