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Urachal remnants: sonographic demonstration in children
A A Cacciarelli1, E J Kass, S S Yang
1Department of Diagnostic Radiology, William Beaumont Hospital, Royal Oak, MI 48072.
Insights
A common finding in pediatric bladder sonograms is a small, hypoechoic structure, often a normal urachal remnant. This finding should not be mistaken for pathology unless infection or obstruction symptoms are present.
Area of Science:
- Pediatric Radiology
- Medical Imaging
- Urology
Background:
- The urachus is a fetal structure that typically obliterates after birth.
- Persistence or remnants of the urachus can sometimes be identified in children.
- Sonography is a primary imaging modality for evaluating pediatric urinary tract abnormalities.
Purpose of the Study:
- To describe a common sonographic finding in the pediatric urinary bladder.
- To determine the nature of a frequently observed hypoechoic structure on pediatric bladder sonograms.
- To differentiate normal anatomical variants from pathological conditions in pediatric bladder imaging.
Main Methods:
- Retrospective review of 100 pediatric bladder sonograms.
- Identification and characterization of a specific hypoechoic structure.
- Surgical removal and pathological examination of one identified structure.
Main Results:
- A small, elliptical, hypoechoic structure was observed in 62% of pediatric bladder sonograms.
- Pathological examination of a surgically removed structure confirmed it as a normal urachal remnant.
- The finding was located on the middle of the anterosuperior surface of the urinary bladder.
Conclusions:
- The observed hypoechoic structure represents a common and normal finding in pediatric bladder sonography.
- This finding, a urachal remnant, should not be misdiagnosed as pathology.
- Clinical correlation with signs and symptoms of infection or bladder obstruction is crucial for accurate diagnosis.
Abstract:
On 62 of 100 pediatric bladder sonograms a small, elliptical, hypoechoic structure was observed on the middle of the anterosuperior surface of the urinary bladder. One of the these structures was removed surgically, and pathologic examination disclosed a normal urachal remnant. Since it is a common sonographic finding in children, it should not be mistaken for a pathologic process unless it is accompanied by signs and symptoms of infection or bladder obstruction.