Learning objectives
To describe the embryology and anatomy of the normal urachus.
To describe the spectrum of radiological findings for each different type of urachal anomaly.
Discuss the management and potential complications of these anomalies.
Background
Increasing use of radiological imaging has shown that urachal anomalies are now more common than previously thought.
The spectrum of urachal anomalies includes a patent urachus,
an umbilical-urachal sinus,
a vesicourachal diverticulum and urachal cyst.
A patent urachus isan elongated patent connection between the bladder and the umbilicus.
An umbilical-urachal sinus is depicted as a blind focal dilatation at the umbilical end,
whereas a vesicourachal diverticulum is a focal outpouching at the vesical end.
Urachal cysts are visualized as midline fluid-filled sacs most frequently located...
Findings and procedure details
Findings
The terms urachus,
urachal cancer and urachal adenocarcinoma were searched using picture archiving and communications software (PACS) over a 10 year period from March 2008 -2018.
There were 217 patients who had an imaging study (ultrasound,
CT or MRI) of which 2 (1%) patients had a urachal adenocarcinoma.
127 (59%) patients had a urachal anomaly and 71 (33%) were normal.
18 (7%) patients had an alternative diagnosis.
Embryology development and anatomy
The urachus is a ductal remnant that arises embryologically,
originating from the involution...
Conclusion
Early detection of urachal anomalies is important as they can cause significant morbidity and rarely mortality.
Thus understanding of the spectrum of these anomalies and the radiological findings is crucial to ensure that these anomalies are detected early and thus appropriately treated.
References
1) Villavencio.
Imaging of the urachus: anomalies,
complications and mimics.
Radiographics 2016.
2) Yu JS,
Kim KW,
Lee HJ,
Lee YJ,
Yoon CS,
Kim MJ.
Urachal remnant diseases: spectrum of CT and US findings.
Radiographics 2001;21(2):451-461.
3) Yeats M,
Pinch L.
Patent urachus with bladder eversion.
J Pediatr Surg 2003;38(11):E12–E13.
4) Yu JS,
Kim KW,
Lee HJ,
Lee YJ,
Yoon CS,
Kim MJ.
Urachal remnant diseases: spectrum of CT and US findings.
RadioGraphics 2001;21(2):451–461.
5).
Cilley RE.
Disorders of the umbilicus.
In: Fletcher J,
ed....