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Copyright of Journal of the Japanese Society of Pediatric Surgery is the property of Japanese Society of Pediatric Surgeons and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Croatian Veterinary Reports / Hrvatski Verinarski Vjesnik is the property of Croatian Veterinary Chamber and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The urachus is a tubular structure that is apparent on the third week and connects the ventral cloaca to the yolk sac, as a progression from the allantois. Following the normal regression procedure, the urachus remains as the median umbilical ligament. Urachal remnants are present in 1.03% of paediatric patients while in 92.5% of cases represent incidental findings. Urachal anomalies are classified in four types as patent urachus (50-52%), urachal sinus (15%), urachal cyst (30%) and urachal diverticulum (3-5%). Ultrasound scan is the most commonly performed diagnostic imaging study. In case of symptomatic urachal remnants, surgical excision is indicated. Asymptomatic urachal remnants that are diagnosed at the neonatal period or early infancy should be watched up to 6 months of age, as they are likely to resolve. In persistent or symptomatic urachal remnants there is a risk of inflammation or even malignancy development, therefore we believe that there is indication for preventive surgical excision that may be performed either open or laparoscopically or by robot-assisted laparoscopy. [ABSTRACT FROM AUTHOR]

Introduction: The vesico-allantoic cyst is a communication between the fetal bladder and the allantois through a patent urachus. Case Report: We describe a 17-week of gestational age (WGA) fetus with a 40 x 30 mm vesico-allantoic cyst. At 19 WGA, ultrasound (US) detected bilateral dilatation of renal pelvis (5-6 mm), hydroureters, and hypospadias. Amniotic fluid, umbilical cord flow, and fetal biometry were regular. Due to uncertain prognosis, the parents opted for legal termination of pregnancy. Autopsy confirmed the prenatal findings, also revealing intestinal malrotation and Meckel's diverticulum. Discussion/Conclusion: Probably an initial urinary tract obstruction occurred, not yet affecting the amniotic fluid volume, but evident as pyelectasis. This case highlights the possibility that genito-urinary and intestinal anomalies may be found in association with the vesico-allantoic cyst. [ABSTRACT FROM AUTHOR]

Patent urachus is a type of urachal anomaly in which the urachus does not tail off but remains connected to the bladder in the umbilicus. The prevalence of patent urachus is very low. Herein, we report a case of patent urachus ruptured and exposed to amniotic fluid in utero. In this case, the size decreased after the second trimester, which was thought to be due to rupture in utero. After delivery, patent urachus was confirmed by inserting a foley catheter, which runs through a ruptured cyst on umbilical cord insertion. The day after delivery, the neonate underwent surgical excision of the urachal cyst and closing umbilicus. The mechanism of patent urachus rupture is unknown. As the fetus matures, it is thought that the higher intravesical pressure may affect the rupture of the cyst. Patent urachus could be ruptured in the uterus spontaneously, and surgical correction is needed. Therefore, prenatal differential diagnosis is important. [ABSTRACT FROM AUTHOR]

Bladder prolapse through a patent urachus is rare. We present a newborn with an unusual exophytic, erythematous umbilical mass. Voiding cystography readily demonstrated continuity of the bladder dome with the umbilical mass, confirming bladder prolapse through a patent urachus. The diagnosis of bladder prolapse was rapidly made in a second newborn with similar imaging and clinical findings and confirmed by cystography. We discuss the embryology of this condition including the association with a vesico-allantoic cyst in utero. Pre- and postnatal images are presented. The use of cystography in diagnosis is emphasized. [ABSTRACT FROM AUTHOR]

A two-day-old female cross bred Jersey calf was presented with history of dribbling of urine through the umbilicus, but not passing urine through the natural urethral opening since birth. The condition was diagnosed as persistent urachus and congenital imperforate urethra based on the history, clinical signs, radiographic and ultrasonographic findings. Under general anaesthesia, the stalk of pervious urachus was identified, carefully ligated and separated through a ventral mid-line laparotomy. The patency of the external urethra was accomplished by gentle digital pressure. The animal had an uneventful recovery. [ABSTRACT FROM AUTHOR]

Objective: The urachus is a thin fibromuscular tubular structure that connects the apex of the bladder and the umbilicus. Its lumen normally obliterates at the 6th week of pregnancy and remains as a dysfunctional remnant called the median umbilical ligament in adult life.[1] Patent urachus refers to an anomaly that occurs with failure of obliteration of the urachus. It is a rare anomaly with a frequency of 1 to 2.5 per 100000 live births.[2] While it can be detected sonographically with findings such as megacystis and umbilical cord cyst in the first trimester, no sonographic finding may be detected in cases with partial failure in obliteration of the urachus. Cases that are not detected in the prenatal period may become symptomatic in the neonatal period and usually present with edematous umbilical cord, wetness in the umbilical region, or recurrent umbilical infections.[3] We aimed to share the follow-up and management of our case with patent urachus and progressively increasing megacystis since the first trimester. Methods: Computer-based and ultrasonography records of a patent urachus case with megacystis and umbilical cord cyst, who applied to the Perinatology outpatient clinic of Prof. Dr. Cemil Taşçıoğlu City Hospital at the 12th week of pregnancy, were scanned retrospectively from the hospital software and the history of the ultrasonography device. Fetal ultrasonography examination was performed using Mindray Resona 7 device and its 1.2-6 MHz convex abdominal probe. Ultrasonography findings and patient history were noted. Case: A 24-year-old gravida 1 pregnant woman referred to our clinic due to megacystitis was admitted to our clinic at 12 weeks of gestation. On examination, the superiorinferior diameter of the bladder was 12.9 mm and it was evaluated as megacystitis. Left renal anteroposterior diameter was measured as 3.6 mm. Chorionic villus sampling was done to the patient at this gestational week and it was concluded as normal karyotype. In the examination performed at the 15th gestational week, the bladder superior-inferior diameter was 72 mm, and an umbilical cord cyst and a single umbilical artery were observed. Vesicocentesis was performed on the patient and 85 cc of urine was drained from the fetal bladder (Figure 1-2). After the procedure, the bladder diameter was measured as 11 mm, and fetal kidneys were observed as hyperechoic in the sonographic examination (Figure 3). Results of urine sampling: Na 104 mEq/L, Cl 82 mEq/L, urine osmolarity 275 mOsm/L, beta-2 microglobulin 16.1 mg/L, Ca 9.6 mEq/L, total protein 0.7 mg/dl. At the patient's admission 72 hours later, the vesicocentesis procedure was repeated and approximately 40 cc of urine sample was taken. Results were reported as Na 136 mEq/L, Cl 107 mEq/L, urine osmolarity 216 mOsm/L, beta-2 microglobulin 11.9 mg/L, Ca 9.6 mEq/L, total protein 3.1mg/dl. The patient and her husband were informed about the possible prognosis and termination option at the 17th gestational week due to high Na, Cl, Ca, beta-2 microglobulin and urine osmolarity as a result of vesicocentesis, recurrence of megacystis in the ultrasound examination after vesicocentesis, bilateral echogenic monitoring of the kidneys and anhydramnios (Figure 3). At the request of the family, the fetus was terminated. No additional findings were observed in the terminated fetus, except for the pathologies detected during inspection. Since the family did not want an autopsy, it was not possible to comment on interal. Results: First trimester sonography is becoming increasingly important in evaluating fetal anatomy and detecting major anomalies. Detection of megacystis in the first trimester is almost always simple and is among the first noticeable findings in sonographic examination. The incidence of megacystis in the first trimester is 1 in 1800, and in almost half of these cases, it is observed that the megacystis resolves within 2 weeks.[4] The prognosis usually depends on the width of the megacystis. Megacystis larger than 15 mm has been associated with a poor prognosis. Megacystis smaller than 15 mm usually resolves spontaneously in approximately 90% of cases without aneuploidy, and this is attributed to a temporary functional neurogenic bladder secondary to a delay in the development of autonomic innervation.[1,4] In the case we presented, the fact that megacystis is close to the border associated with poor prognosis in the literature, recurrence of megacystis after vesicocentesis, hyperechoic appearance in bilateral kidneys, and subsequent anhydramnios were warnings about poor prognosis. Conclusion: In such cases, performing ultrasonography in expert hands, sharing the current findings and possible prognosis in detail with the family, and making a joint decision by interviewing the family will be decisive in the management of the cases. [ABSTRACT FROM AUTHOR]

Congenital atresia of intestines in anus and rectum part is commonly reported in newborn calves. This case report discusses cases of atresia ani et recti and its surgical correction. A circular incision was made on the bulge of the anus and patency of opening was maintained by the application of interrupted sutures. The animal's defecation improved slowly. [ABSTRACT FROM AUTHOR]

Caudal Duplication Syndrome (CDS) is a rare congenital anomaly and has an the association between malformations and duplications of the gastrointestinal and genitourinary systems and neural tube defects. We report a rare case of caudal duplication syndrome, a disorder associating partial or complete duplication of the spine or spinal cord and of other caudal structures, such as urogenital tract and variable degrees of neurological dysfunction. Also associated with caudal regression in the form of sacro-coccygeal agenesis. [ABSTRACT FROM AUTHOR]

Simultaneous presentation of omphalocele, patent urachus, and umbilical cyst is very rare. There is wide range of differential diagnosis for umbilical cyst. Accurate assessment of umbilical cysts is important to evaluate other abnormalities. [ABSTRACT FROM AUTHOR]

An urachus is a remnant of allantois in embryo development constituting a connection between the dome of the bladder and umbilicus. It develops on day 16 after conception and closes during the pregnancy to form the median umbilical ligament. Patent urachus results from a failure in closing its lumen in 10-12 gestational weeks. This anomaly occurs in 1-2 babies in 100,000 births. We present the case of patent urachus. In 20 gestational weeks, a dilatation of the umbilical cord with an anechoic mass with a transverse dimension of 19 x 12 mm starting from the fetal insertion and length of 30 cm was seen on ultrasound without any other fetal and placental disorders. Histology showed cystic edema. Prenatal diagnosis of patent urachus can be difficult because this pathology may be mistaken with other, more dangerous causes of cord cysts; thus, the occurrence of cord cysts should be closely monitored. [ABSTRACT FROM AUTHOR]

A giant umbilical cord is a rare finding in mature newborns and originates from different developmental etiologies. We report on a case of a mature female newborn presenting a 50 × 8-cm giant umbilical cord without further malformations. Antenatal sonographic findings of a diffuse giant umbilical cord, elevated creatinine levels of 1.3 mg/dL in umbilical cord edema, gross and histopathological findings of allantoic remnants, and umbilical urinary discharge lead to the diagnosis of a patent urachus with retrograde micturition into the umbilical cord. Postnatal surgical repair was required. In antenatal sonography, cystic and diffuse changes should be considered in the differential diagnosis of a giant umbilical cord. In cases of diffuse enlargement, elevated umbilical creatinine can support the diagnosis of a patent urachus with open leakage into the Wharton's jelly. Appropriate surgical management is required. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to clarify the prenatal and postnatal clinical courses of an urachus identified as an allantoic cyst in the umbilical cord. Methods: Allantoic cysts in the umbilical cord were identified in five fetuses over the past 12 years at our hospital. The prenatal and postnatal clinical courses of these patients were retrospectively reviewed. Results: The presence of allantoic cysts in the umbilical cord was first detected at 15 to 27 weeks of gestation. The cysts subsequently became enlarged, reaching a maximum diameter of 34 to 61 mm at 17 to 32 weeks of gestation. The cysts then suddenly disappeared due to spontaneous rupture at 26 to 35 weeks of gestation. After being born at 38 (35-39) weeks of gestation, four patients were diagnosed with a patent urachus requiring surgery in the infantile period and one was diagnosed with an urachal cyst, which is currently being observed without surgery. Conclusion: The presence of an urachus identified as an allantoic cyst in the umbilical cord is frequently associated with spontaneous rupture during the prenatal period, resulting in a patent urachus after birth that requires surgical intervention. [ABSTRACT FROM AUTHOR]

We present a unique case of umbilical cord cysts of allantoic and omphalomesenteric remnants with progressive cord edema during pregnancy. Enlargement of the umbilical cord was observed initially at 28 weeks’ gestation; the cord cysts were first recognized at 17 weeks. At 37 weeks, a cesarean section was performed and a male infant weighing 2,300 g was delivered. The entire length of the umbilical cord was 80 cm; the 50-cm proximal portion was strikingly edematous and was 7 cm in diameter. On the 1st day of life, operative exploration was undertaken via an infraumbilical incision. It was evident that a patent urachus protruded from the bladder. The lesion was excised and the bladder was closed in a two-layer anastomosis. Histologically, the intestinal epithelium was connected to the transitional epithelium at the top of the urachus, indicating allantoic remnants fused with omphalomesenteric remnants. Such a case has not been reported previously. It was considered that the overflow of urine from allantoic remnants to omphalomesenteric remnants caused the extraordinary edema of the umbilical matrix. Based on our experience, finding progressive umbilical cord edema may indicate a patent urachus co-existing with allantoic and omphalomesenteric remnants. Copyright © 2009 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Patent urachus cyst is a rare umbilical anomaly, which is poorly detected prenatally and frequently confounded with pseudo bladder exstrophy or omphalocele. A 27-year-old woman was referred to our prenatal diagnosis centre at 18 weeks of gestation after diagnosis of a megabladder and 2 umbilical cord cysts. Subsequent 2D, 3D and 4D ultrasound examinations and fetal magnetic resonance imaging (MRI) revealed a typical umbilical cyst and an extra-abdominal cyst, communicating with the vertex of the fetal bladder through a small channel that increased in size when the fetus voided urine. Termination of pregnancy occurred at 31 weeks because of associated cerebral septal agenesis, and autopsy confirmed the prenatal diagnosis of urachus cyst. Few cases of urachus cyst diagnosed prenatally are reported in literature, but none were associated with other extra-abdominal disorders and none used 3D, 4D and fetal MRI. Our case illustrated the efficiency in prenatal diagnosis of 3D and 4D ultrasound examinations. This could help pediatrician surgeons to explain to a couple about neonatal surgical repair and plastic reconstruction in the prenatal period. Copyright © 2008 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

A patent urachus, which is typically diagnosed as leakage from the umbilicus postnatally, can present as an allantoic cyst in the umbilical cord antenatally. We report a case of a patent urachus with an allantoic cyst diagnosed via fetal MR imaging at 24 weeks' gestation. Early detection allowed for appropriate counseling and prompt corrective surgery after birth. [ABSTRACT FROM AUTHOR]

Cystic masses of the umbilical cord have been detected in the second and third trimesters of pregnancy in association with fetal abdominal wall defects and chromosomal anomalies. We present a case of an umbilical cord pseudocyst diagnosed using routine ultrasound at the 20 weeks of gestation. Serial sonography followed the progression of the cystic masses. A 2960-g male infant was delivered at term, in whom a patent urachus was detected. The infant underwent repair with closure of the patent urachus and plastic reconstruction of the abdominal wall, and the postoperative course was uneventful. This case demonstrated an uneventful outcome despite the persistent multiple cord cysts. [ABSTRACT FROM AUTHOR]

Persistent patent urachus with other accompanying anomalies like urethral obstruction and uroperitonium quickly deteriorates animal conditions which necessitate prompt surgical intervention and animal salvage. A 10-day-old calf was referred to clinic with mildly distended abdomen, history of umbilical dribbling and no signs of normal urination since birth. On clinical laboratory results and ancillary tests persistent patent urachus complicated with imperforated urethra and uroabdomen was diagnosed. After abdominocentesis under ultrasonography, exploratory laparotomy was performed. Persistent urachus was removed and attempts failed to insert a catheter into urethra. Then, a Foley catheter was placed into bladder and passed through subcutaneous tissues and exited lateral to the umbilical region from skin. The calf voided via the catheter right after standing up and showed clinical improvement for the two months after-discharge follow up. [ABSTRACT FROM AUTHOR]

Allantoic cysts are a somewhat rare entity. They are identifiable on antenatal ultrasound examination but are not easily distinguishable from pseudocysts, which are often associated with a poor prognosis. Their etiology remains obscure and obstructive uropathies have been proposed to be one of the underlying mechanisms. We report on a case in which both allantoic cysts and a patent urachus were detected antenatally and turned out to be associated with posterior urethral valves (PUV). The cysts were first seen in the early second trimester, with a full fetal bladder and patent urachus. They disappeared by the 29 [ABSTRACT FROM AUTHOR]

In this paper, we aim to highlight a case report of a rare association of anomalies comprising patent urachus, double urethra and development of testicular teratoma. [ABSTRACT FROM AUTHOR]

Allantoic cysts of the umbilical cord are extremely rare anomalies. Only few cases have been reported in the postnatal life. The etiopathogenesis is still obscure. We describe a case of allantoic cyst and patent urachus in a newborn associated with hypospadias and meatal obstruction. We also present the review of literature regarding this entity, embryology and etiopathogenesis. [ABSTRACT FROM AUTHOR]

Two male children with ano/recto-urethral fistula without anorectal malformation were managed in our institute. These patients had variable clinical manifestations and associated anomalies including congenital urethral hypoplasia, renal agenesis and patent urachus. Both were treated successfully according to their status of disease-complexes. This is to discuss these rare cases and its management with review of the literature. [ABSTRACT FROM AUTHOR]

Three calves were presented with history of seepage of urine through the umbilical region since its birth and soft reducible swelling at the umbilicus. Clinical examination revealed hernial ring. Contrast radiographic examination revealed accumulation of radio dense contrast agent with in the distended urachus. A hyperechoic area of urachus was observed by ultrasound examination. Based on the clinical, radiological and ultrasonographic examination, the condition was diagnosed umbilical hernia with patent urachus. Surgical correction was made with herniorrhaphy and laparotomy. The animal made an uneventful recovery. [ABSTRACT FROM AUTHOR]

Here, we present a pictorial description of a rare case of patent urachus in a neonate and its management. [ABSTRACT FROM AUTHOR]

A neonate with patent urachus (PU) who later developed hypertrophic pyloric stenosis (HPS) is being reported. The newborn was first operated for PU; post-operatively he developed persistent vomiting and radiological workup confirmed HPS. Pylo-romyotomy was performed with an uneventful recovery. [ABSTRACT FROM AUTHOR]

Umbilical cord anomalies can often be detected prenatally by ultrasound, but a definitive prenatal diagnosis is not always possible. We present a case with increasing edema of the Wharton's jelly followed by the development of pseudocysts in the proximal umbilical cord due to a patent urachus. The first abnormal findings were detected by ultrasound in the 14th week of gestation. Differential diagnoses and their influence on surveillance and birth management are discussed. [ABSTRACT FROM AUTHOR]

Ectopic scrotum is a rare condition and has been reported in association with other urological abnormalities. We present a case with an associated patent urachus and a brief discussion on the possible mechanism to explain this deformation. [ABSTRACT FROM AUTHOR]

A very rare case of patent urachus associated with a completely patent omphalomesenteric duct is presented. Although the diagnosis of anomalies and infantile diseases of the umbilicus is not generally considered to be difficult given their clinical signs and contrast radiography, in this case, clinical radiography could not be used to make the diagnosis because of the patient's hypersensitivity to iodine. Treatment of the umbilical remnants involves complete surgical excision and reconstruction of the umbilicus. [ABSTRACT FROM AUTHOR]