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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]

Aim: To report our experience in the laparoscopic management of symptomatic urachal remnants (URs) in adults. Patients and Methods: A retrospective study included all patients who underwent laparoscopic excision of URs during the period January 2015–January 2020. The following data were retrieved from the files of the patients: demographic data, clinical presentations, intra-operative findings, the procedure performed, operative details, intraoperative or post-operative complications and follow-up period mentioned in the files for those patients. Results: The study included 10 patients (four males and six females) with a mean age of 27.8 ± 11.0 years. URs were discovered preoperatively in all patients except one patient who was diagnosed intraoperatively. URs were associated with other pathologies in four patients (40%) that required two simultaneous surgical procedures. Eight patients (80%) presented with simple umbilical discharge and were diagnosed easily by ultrasonography. All patients were managed successfully with laparoscopic excision and umbilical sparing technique. Excision of the dome of the bladder was done on the selective approach to one patient. No patients showed early post-operative complications. Only one patient had stitch sinus 6 months postoperatively due to a concomitant hernia repair rather than due to the excision of the URs. Conclusions: Laparoscopic excision of symptomatic urachus is a feasible procedure even when the excision of the bladder is required. It could be performed successfully with other pathologies. It is associated with a low incidence of complications. Laparoscopy allows good visualisation and complete excision that leads to almost no recurrence rate.

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]

A long diffuse giant umbilical cord (GUC), caused by umbilical cord edema associated with a patent urachus, is an extremely rare anomaly. While patients with diffuse GUC appear to experience no significant complications and a good prognosis, little is known about their etiology and prenatal course. Here, we report the first case of prenatally diagnosed diffuse GUC resulted from patent urachus in a monochorionic diamniotic twin with selective intrauterine growth restriction. This case indicates that GUC is epigenetic and unrelated to multiple births.

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]

Ingestion of foreign body may induce complications such as perforation, impaction, or penetration. Diagnosis rarely made preoperatively due to clinical symptoms are usually nonspecific and can mimic other surgical conditions. A 69-year-old male presented to emergency department with vague abdominal pain for few days. Following a clinical evaluation and computed tomography scan of the abdomen, provisional diagnosis of urachal carcinoma was made. As the result of urachal excision with partial cystectomy including fishbone were resected, pathology revealed benign urothelium.

Abstract Background To explore the association between patent urachus and bladder outflow obstruction (BOO). A retrospective review of patient records over a 35-year period (1983–2018) with complete patent urachus was performed. Antenatal ultrasound findings were noted, and postnatal investigations included ultrasound (US), micturating cystourethrogram (MCUG), functional nuclear medicine scans (MAG3, DTPA, and DMSA), and serum creatinine. Associated anomalies and management in all patients were analyzed. Results Sixty-six patients with all types of urachal remnants were identified of whom only 16 had a patent urachus. All presented clinically with a discharging umbilicus, 10/16 confirmed on MCUG and 4 had umbilical cord cysts on antenatal US. Twenty-five percent had associated bladder outlet obstruction (BOO): etiologies included atresia of posterior urethra, congenital urethral hypoplasia, urethral atresia with prune belly syndrome, and sacrococcygeal teratoma. Vesicoureteral reflux (VUR) was confirmed in 37%, and four of them had bladder outlet obstruction (BOO). Conclusion With patent urachus, bladder outflow obstruction occurs in the minority. Based on our findings, we commend US and cystogram to document VUR. The isolated PU should be treated nonoperatively up to a year of age. Renal function should be checked with the finding of VUR. The etiopathogenesis of the condition remains uncertain.

We are reporting an umbilical cyst detected at early trimester which mimicking bladder exstrophy occulta. A 3-cm umbilical cord cyst and a slight ventrally located urinary bladder beneath the cord insertion site was detected at 14th gestational weeks, which decreased in size and disappeared at 28th week. A term female neonate born with a 2-cm defect over the base of the umbilical cord, revealed a patent urachal fistula, and a part of the herniated urinary bladder. Detection of a vanished umbilical cord cyst has to keep aware of, making an immediate definite diagnosis and management of urachal anomaly.

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 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.

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]

The space of Retzius is an important anatomic location for pathology. Pathology in the space of Retzius is more common than previously believed, especially as more cases are discovered with increased use of cross-sectional imaging. Knowledge of the anatomy of the Space of Retzius is crucial for identifying and distinguishing between benign and pathological findings. This paper uses several case examples to discuss benign etiologies, including normal tissue or a foreign body. The paper also demonstrates a case series with pathologic findings in the Space of Retzius under the broad categories of infection, neoplasm, hemorrhage, or urine extravasation. Understanding of the anatomy and these example cases can improve the diagnostic accuracy of radiologists. • Knowledge of the anatomy of the Space of Retzius is crucial for identifying and distinguishing between benign and malignant findings. • Benign etiologies may include normal tissue (e.g., patent urachus), foreign body (e.g., penile implant reservoir), infection, neoplasm, hemorrhage, or urine extravasation following bladder perforation. • Malignant findings are rare and include urachal carcinoma and umbilical metastasis. [ABSTRACT FROM AUTHOR]

Urachal abnormalities are infrequent pathologies characterized by the failure of obliteration of the urachal canal, resulting in a persistent fibrous cord. The initial diagnosis approach can be done with ultrasonography; however, computed tomography is considered a standard diagnostic method. The preferred method for relieving symptoms and reducing recurrence is surgical excision. This is a case of a 45-year-old man with recurrent urinary tract infections, suprapubic pain, and umbilical fetid discharge who underwent laparoscopic umbilicus-sparing excision., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Varela Barraza et al.)

A patent urachus is the presence of structures found early in pregnancy, which could be associated with other abnormality in 46% cases. Hemangiomas are benign tumors and are more common in the skin. Umbilical cord hemangiomas are very rare, with fewer than 50 cases described in the literature. Here we report a clinical case of a neonate with a prenatal diagnosis of an umbilical cord hemangioma and a patent urachus. We would like to draw attention to the differential diagnosis of cord masses, as well as to the importance of early diagnosis and the appropriate management of the newborn. To our knowledge, this is the first case reported of a newborn diagnosed with this association.

Abscess formation of the falciform or round ligament of the liver is rare. A 15-year-old boy was diagnosed with Hirschsprung's disease after birth and underwent surgery for transverse colostomy at the site of the left upper abdomen in the neonatal period. A radical operation for Hirschsprung's disease was performed with a widely extended incision of the colostomy at 3 months of age. When he was 14 years old, he presented with lower abdominal pain due to a patent urachus. Six months after excision of the patent urachus, he returned to our outpatient clinic, showing pain and a palpable mass at the middle upper abdomen. We report herein a case of abscess formation of the round ligament of the liver after surgical resection of a patent urachus. We also review previous literature and discuss the possible pathogenesis and mechanisms of this phenomenon.

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Background: To explore the association between patent urachus and bladder outflow obstruction (BOO). A retrospective review of patient records over a 35-year period (1983–2018) with complete patent urachus was performed. Antenatal ultrasound findings were noted, and postnatal investigations included ultrasound (US), micturating cystourethrogram (MCUG), functional nuclear medicine scans (MAG3, DTPA, and DMSA), and serum creatinine. Associated anomalies and management in all patients were analyzed. Results: Sixty-six patients with all types of urachal remnants were identified of whom only 16 had a patent urachus. All presented clinically with a discharging umbilicus, 10/16 confirmed on MCUG and 4 had umbilical cord cysts on antenatal US. Twenty-five percent had associated bladder outlet obstruction (BOO): etiologies included atresia of posterior urethra, congenital urethral hypoplasia, urethral atresia with prune belly syndrome, and sacrococcygeal teratoma. Vesicoureteral reflux (VUR) was confirmed in 37%, and four of them had bladder outlet obstruction (BOO). Conclusion: With patent urachus, bladder outflow obstruction occurs in the minority. Based on our findings, we commend US and cystogram to document VUR. The isolated PU should be treated nonoperatively up to a year of age. Renal function should be checked with the finding of VUR. The etiopathogenesis of the condition remains uncertain. [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]

We report a term neonate with a congenital patent urachus with bladder prolapse. Initial antenatal fetal morphology ultrasound at 13 weeks gestation revealed a large midline pelvic cyst communicating with the bladder which disappeared on subsequent 23 week ultrasound and instead a small umbilical mass was seen, suspicious of omphalocoele. At birth, an umbilical eversion of the bladder dome through a patent urachus was found and operated on a second day of life with excision of the prolapse and bladder closure. There were no other co-existing anomalies and postoperative complications. With increased reporting on bladder prolapse through a patent urachus, we present a case report with a brief review of published literature. [ABSTRACT FROM AUTHOR]

A prolapsed and everted bladder through a widely patent urachus with an absent omphalocele is considered as an extremely rare and unique case, which requires emergency treatment and surgical intervention. A newly born baby was born at term and then referred from a district hospital for a mass at the umbilical region. She was referred as a case of gastroschisis, but she was eventually found to have a rare patent urachus with bladder eversion and prolapse onto the abdominal wall. The prolapsed bladder was repaired without any complications, and an umbilicoplasty was performed successfully. The infant recovered uneventfully and without any difficulty in voiding. A significant reduction in bladder dome inflammation as well as in mucosal necrosis can be obtained by performing the repair procedure as soon as possible. [ABSTRACT FROM AUTHOR]

Patent urachus is a rare congenital abnormality. Since its first description by Cabriolus in 1550, few cases have been reported. A 26-year-old Vietnamese primigravida presented at 20 weeks of gestation for evaluation of a cystic mass in the umbilical cord, which was first discovered at week 13 of pregnancy by ultrasound scan. The cystic mass originated from the root of the umbilical cord, connected to the urinary bladder, and no intestinal contents were enclosed within. Doppler ultrasound assessment showed that the single umbilical artery existed within the normal range. The progression of the umbilical cyst continued to be screened, but the mass disappeared on ultrasound images at 27 weeks of gestation. This led to the consideration of the cyst’s rupture. After 38 gestational weeks, the pregnant woman delivered a 3350g male infant via cesarean section because of an obstructed vaginal labor. The following days, a stream of urine was recorded leaking out from the umbilical mass whenever he cried. Seven weeks after delivery, an open surgical approach was successfully performed. The baby is now 43 months of age, growing and developing normally. Since an allantoic cyst with patent urachus is a rare clinical entity, early discovery, close monitoring and accurate diagnosis through ultrasound in the prenatal period may consequently allow clinicians to have suitable attitudes towards management when the infant is born.

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]

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.

Aim: To report our experience in the laparoscopic management of symptomatic urachal remnants (URs) in adults., Patients and Methods: A retrospective study included all patients who underwent laparoscopic excision of URs during the period January 2015-January 2020. The following data were retrieved from the files of the patients: demographic data, clinical presentations, intra-operative findings, the procedure performed, operative details, intraoperative or post-operative complications and follow-up period mentioned in the files for those patients., Results: The study included 10 patients (four males and six females) with a mean age of 27.8 ± 11.0 years. URs were discovered preoperatively in all patients except one patient who was diagnosed intraoperatively. URs were associated with other pathologies in four patients (40%) that required two simultaneous surgical procedures. Eight patients (80%) presented with simple umbilical discharge and were diagnosed easily by ultrasonography. All patients were managed successfully with laparoscopic excision and umbilical sparing technique. Excision of the dome of the bladder was done on the selective approach to one patient. No patients showed early post-operative complications. Only one patient had stitch sinus 6 months postoperatively due to a concomitant hernia repair rather than due to the excision of the URs., Conclusions: Laparoscopic excision of symptomatic urachus is a feasible procedure even when the excision of the bladder is required. It could be performed successfully with other pathologies. It is associated with a low incidence of complications. Laparoscopy allows good visualisation and complete excision that leads to almost no recurrence rate., Competing Interests: None

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]

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.

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]