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patent urachus

Friday 6 June 2008

congenital patent urachus, persistant urachus

Definition: Congenital patent urachus is an extremely rare condition with an incidence of 1-2.5:100’000 deliveries. Males are affected twice as often as females.

Images

- 8yo m with persist. urachus. There R 2 other wet umbilicus rests: allantoid & omphalomesenteric

On prenatal US, the presence of a direct communication between the fetal bladder and the umbilical cord cyst confirms the diagnosis of a patent urachus.

This pathognomonic feature, however, is not always apparent prenatally.

Congenital patent urachus is rarely associated with other anomalies such as posterior urethral valves, and when isolated, not related to chromosomal defects.

When detected prenatally, congenital patent urachus should lead to close monitoring and follow-up of the mother and fetus because of a possible compression effect of the cystic mass on the umbilical vessels, particularly at term and during labor, resulting in fetal compromise as in the present case.

The preferred mode of delivery may be discussed based on considerations the size of the lesion.

Associations

- giant umbilical cord

References

- Meyer W, Gauthier D, Bieniarz A, Warsof S. Completely patent urachus. In: www.thefetus.net; 1991

- Nobuhara KK, Lukish JR, Hartman GE, Gilbert JC. The giant umbilical cord: an unusual presentation of a patent urachus. J Pediatr Surg 2004;39:128-129

- Persutte WH, Lenke RR, Kropp K, Ghareeb C. Antenatal diagnosis of fetal patent urachus. J Ultrasound Med 1988;7:399-403

- Schiesser M, Lapaire O, Holzgreve W, Tercanli S. Umbilical cord edema associated with patent urachus. Ultrasound Obstet Gynecol 2003;22:646-647

- Sepulveda W, Bower S, Dhillon HK, Fisk NM. Prenatal diagnosis of congenital patent urachus and allantoic cyst: the value of color flow imaging. J Ultrasound Med 1995;14:47-51

- Ueno T, Hashimoto H, Yokoyama H, Ito M, Kouda K, Kanamaru H. Urachal anomalies: ultrasonography and management. J Pediatr Surg 2003;38:1203-1207