Urachal Remnant - Advanced Radiology Teachingadvancedradteaching.com/teachingfiles/235.pdfumbilicus....
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Urachal Remnant Joseph Junewick, MD FACR 01/18/2010 History 2 month old male with omphalitis and occasional drainage from the umbilicus. Diagnosis Urachal Remnant Discussion The umbilicus contains remnants of the allantois (urachus) and vitelline (omphalomesenteric) duct, both of which may be variably patent or contain cysts. The vitelline duct connects the distal ileum to the the umbilicus and the urachus connects the urinary bladder to the umbilicus. Meckel diverticulum is the most common vitelline duct abnormality. It is present in about 4% of the population, occuring on the antimesenteric border of the distal ileum. It is usually asymptomatic but can be associated with bleeding (especially if it contains ectopic gastric mucosa), intussusception, or enteroliths. Urachal remnants are commonly seen on sonography as focal thickening of the anterior dome of the urinary bladder; rarely an isoechoic cord, sinus or a cord with intervening cysts can be seen extending from the dome of the bladder to the umbilicus. Patients may present with umbilical drainage or omphalitis. Findings US-Isoechoic cord extending from the apex of the urinary bladder and flaring at the level of the umbilicus. Doppler shows hyperemia at the umbilicus. No associated cyst. Reference Nagasaki A, Handa N, Kawanami T. Diagnosis of urachal anomalies in infancy and childhood by contrast fistulography, ultrasound and CT. Pediatr Radiology (1991); 21(5):321-323.
Transcript of Urachal Remnant - Advanced Radiology Teachingadvancedradteaching.com/teachingfiles/235.pdfumbilicus....
Urachal RemnantJoseph Junewick, MD FACR
01/18/2010
History2 month old male with omphalitis and occasional drainage from the umbilicus.
DiagnosisUrachal Remnant
DiscussionThe umbilicus contains remnants of the allantois (urachus) and vitelline (omphalomesenteric) duct,both of which may be variably patent or contain cysts. The vitelline duct connects the distal ileum tothe the umbilicus and the urachus connects the urinary bladder to the umbilicus.Meckel diverticulum is the most common vitelline duct abnormality. It is present in about 4% of thepopulation, occuring on the antimesenteric border of the distal ileum. It is usually asymptomatic butcan be associated with bleeding (especially if it contains ectopic gastric mucosa), intussusception, orenteroliths.Urachal remnants are commonly seen on sonography as focal thickening of the anterior dome of theurinary bladder; rarely an isoechoic cord, sinus or a cord with intervening cysts can be seenextending from the dome of the bladder to the umbilicus. Patients may present with umbilical drainageor omphalitis.
FindingsUS-Isoechoic cord extending from the apex of the urinary bladder and flaring at the level of theumbilicus. Doppler shows hyperemia at the umbilicus. No associated cyst.
ReferenceNagasaki A, Handa N, Kawanami T. Diagnosis of urachal anomalies in infancy and childhood bycontrast fistulography, ultrasound and CT. Pediatr Radiology (1991); 21(5):321-323.
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