Retained pill camera at an entero-uracho-vesical fistula site in a patient with Crohn's disease.
(25/29)
An 18-year-old female patient with Crohn's disease had abdominal pain secondary to a retained pill camera. After several weeks of medical management, the camera spontaneously passed. However, the patient also had an intra-abdominal abscess that worsened, despite medical therapy. Surgical therapy was recommended and a 5cm infected urachal cyst with entero-urachal and vesico-urachal fistulas was discovered. An en-bloc resection of the entire area was performed to include the urachal cyst, the adherent portion of the dome of the bladder, and 15cm of associated ileum. The bladder was repaired, a suprapubic catheter was placed, and an ileo-ileal anastamosis was performed. Microscopic findings were consistent with active Crohn's disease and fistula formation. The entero-uracho-vesical fistula site was likely the site of the retained pill camera. The patient did well postoperatively and was discharged on postoperative day six without complications. (+info)
Haemorrhage into a urachal cyst presenting as an 'acute abdomen'.
(26/29)
A previously well 3 year old Asian girl presented as an emergency with the acute onset of generalized abdominal pain. On examination her abdomen was distended with generalized tenderness and guarding most marked centrally. Under anaesthesia a central abdominal mass arising from the pelvis was palpated which on proceeding to laparotomy was found to be a blood-filled urachal cyst. This was excised and her recovery was uneventful. Subsequent investigations have revealed no associated renal tract abnormalities. (+info)
Sonography of vesical and perivesical abnormalities in children.
(27/29)
Pelvic sonograms of 40 children who had abnormalities related to the bladder and perivesical region were reviewed. The lesions detected were categorized into three groups, intramural, intravesical, and perivesical; in each category, conditions not related to vesical or perivesical anomalies that could mimic such anomalies were encountered. Real-time ultrasonography was most helpful in identifying ectopic ureteroceles. Aperistaltic loops of bowel were found to mimic perivesical cysts. (+info)
Persistent patent urachus with allantoic cyst: a case report.
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Patent urachus results when there is a persistence of an allantois remnant which normally undergoes atresia during embryological development. It can lead to an abdominal wall defect similar in appearance on ultrasound to an omphalocele. A 34-year-old primigravida presented at 19 weeks' gestation for evaluation of a cystic mass arising at the umbilical cord insertion. The initial impression of the referring physician was an omphalocele. The mass arose from the abdominal wall and the umbilical cord inserted into the membranous covering of the mass, which appeared to be fluid-filled and separate from but contiguous with the urinary bladder. Serial sonography followed the progression of the abdominal wall mass. At term, the patient underwent primary Cesarean section with delivery of a 4494-g male infant. The infant underwent repair and closure of the patent urachus and plastic reconstruction of the abdominal wall. When the urachus remains patent, it can lead to a urinary fistula which mimics the ultrasound appearance of an omphalocele. However, patent urachus is associated with a much lower rate of abnormalities than omphalocele, yielding a better fetal prognosis. (+info)
Stage 0 mucinous adenocarcinoma in situ of the urachus.
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Adenocarcinomas of the urinary bladder are rare (1-5% of bladder tumours) and of notoriously poor prognosis. About one third of such tumours arise in urachal remnants related to the bladder. This is believed to be the first report of in situ change in the urachal remnant. The patient presented with mucusuria and computed tomography showed a typical urachal cyst. After excision the cyst was found to contain mucinous adenomatous epithelium but without invasion of the basal lamina. Pathological stage is the best prognostic indicator in urachal tumours. Prompt investigation and management of mucusuria may allow the diagnosis of urachal tumours in this preinvasive stage. (+info)