Laparoscopic management of patent urachus in an adult man

A 35-year-old man presented with recurrent urinary discharge from the umbilicus. A diagnosis of persistent patent urachus was established by magnetic resonance imaging. Radical excision of urachal remnant tissue was accomplished by laparoscopic surgery using four ports. Magnetic resonance imaging is diagnostic in urachal remnants. Radical excision of urachal remnants may safely be done by laparoscopic access.     

A case report of a patent urachus associated with a completely patent omphalomesenteric duct

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.     

Nonoperative management of a patent urachus

Patent urachus accounts for 10% to 15% of all reported urachal abnormalities in the literature. Treatment in the past has relied on immediate surgery. Conservative therapy with bladder catheter drainage, resulting in spontaneous closure, has not been described. We report a case of patent urachus in a 6-day-old infant who presented with urine drainage from the umbilicus. Radiographic studies confirmed a patent urachus. One week of urethral catheterization resulted in spontaneous closure of the patent urachus. This case suggests that initial treatment should consist of urethral catheterization for 1 to 2 weeks, followed by repeat voiding cystourethrogram. If the patent urachus still persists, one should proceed to surgical correction.     

A rare case report of patent vitellointestinal duct causing bowel obstruction in an adult

IntroductionPatent vitellointestinal duct occurs in about 2% of the population which unusually leads to small intestinal obstruction associated with high morbidity and mortality. Here we are reporting an unusual case of patent vitellointestinal duct causing small intestinal obstruction in an adult patient.Presentation of caseA 22-year-old male without any medical illness presented as an emergency with a 3 day hystory of abdominal pain, multiple episode of vomiting and abdominal distention. Distended abdomen and sign of peritonitis were found on abdominal examination. Abdominal X-rays revealed multiple small intestinal air-fluid levels. A patent vitellointestinal duct extending from distal ileum to the posterior wall of the umbilicus was found causing closed loop ileal obstruction during laparotomy. Resection of a vitellointestinal duct along with gangrenous distal ileum and cecum with ileocolostomy was performed. He was discharged on the 8 th postoperative day.DiscussionDiagnosing and management of cause of intestinal obstruction in patients without history of abdominal surgery is very challenging. Early resuscitation and timely surgical intervention of intestinal obstruction due to a rare patent vitellointestinal duct can be life-saving measure.ConclusionThe patent vitellointestinal duct is an uncommon entity in adults and moreover this disorder leading to intestinal obstruction is very rare. Surgeons should be aware of this infrequent cause of small bowel obstruction to allow for early diagnosis and to facilitate better patient outcomes.     

The giant umbilical cord: an unusual presentation of a patent urachus

Umbilical cord anomalies remain a frequent newborn nursery consultation for the pediatric surgeon. The authors report on a giant umbilical cord associated with a patent urachus. Although it is an uncommon anomaly, operative exploration must be carried out to repair the associated urachal remnant.     

Prenatally diagnosed patent urachus with bladder prolapse

We report 2 cases of patent urachus with bladder prolapse, which has a characteristic finding of “disappearance of cyst” antenatally. In the first case, a 34-year-old woman presented at 14 weeks gestation for evaluation of a cyst. Prenatal ultrasonography revealed a cystic mass at the base of the umbilical cord, communicating with the bladder. At 26 weeks gestation, the cyst had disappeared, and a solid mass bulged out inferior to the umbilical cord. At term, the patient delivered a male infant. Examination of the neonate demonstrated mucosal protrusion inferior to the umbilical cord. Catheterization confirmed communication with the bladder. We diagnosed patent urachus with bladder prolapse. In the second case, a 36-year-old woman presented at 19 weeks gestation for evaluation of moderate bilateral hydronephrosis and an abdominal cyst. Prenatal ultrasonography revealed a cystic mass at the base of the umbilical cord, communicating with the bladder. At 26 weeks gestation, the cyst had disappeared. At term, the patient delivered a male infant displaying patent urachus with bladder prolapse. Understanding of the development of urachus is important for prenatal diagnosis, which in turn allows surgery immediately after birth. We showed bladder function after surgery remains good at school age.     

A case of teratoma of the urachus

The paper reports a case of teratoma of the urachus in a 53-year-old patient. The difficulties of diagnosing this pathology are underlined, in particular in relation to the rarity of the site of which no other examples have been reported in the literature.     

A rare case of adenocarcinoma of the urachus

The authors describe a rare case of adenocarcinoma of the urachus in a 68-year-old man. En bloc resection of the dome of the bladder, urachal carcinoma and urachus including the umbilicus was done.     

The surgical treatment of diseases of the patent urachus

In the clinic, 23 patients were operated on the weeping umbilicus. A patent urachus was revealed in 10 patients: its complete patency--in 3, a stone-containing cyst--in 3, phlegmon of the abdominal wall--in 4. Total excision of the urinary duct was performed in all the patients.