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Urachal anomalies: defining the best diagnostic modality
B G Cilento1, S B Bauer, A B Retik
1Department of Urology, Children's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA.
Urology
|July 22, 1998
Summary
Urachal abnormalities in children are diagnosed using physical exams and imaging. Periumbilical drainage suggests urachal sinus or patent urachus, best seen with sinograms, while masses indicate urachal cysts, diagnosed by ultrasound.
Area of Science:
- Pediatric Surgery
- Urology
- Diagnostic Imaging
Background:
- Urachal abnormalities are rare, with limited data beyond case reports.
- A comprehensive review can clarify presentation and diagnosis.
Purpose of the Study:
- To elucidate the presentation and diagnostic methods for urachal abnormalities in pediatric patients.
- To analyze a large cohort experience for improved diagnostic certainty.
Main Methods:
- Retrospective review of 45 pediatric patients with urachal abnormalities (1970-1997).
- Analysis of presenting complaints, diagnostic imaging studies, and treatment outcomes.
- Categorization of abnormalities into urachal sinus, urachal cyst, and patent urachus.
Main Results:
- Common presentations included periumbilical discharge (42%), umbilical cyst/mass (33%), and pain (22%).
- Diagnoses comprised urachal sinus (49%), urachal cyst (36%), and patent urachus (15%).
- Sinograms were diagnostic for sinus/patent urachus; ultrasound was diagnostic for cysts; prenatal diagnosis occurred in one patent urachus case.
Conclusions:
- Accurate diagnosis relies on physical examination and appropriate imaging.
- Sinograms are recommended for periumbilical drainage; ultrasound for periumbilical masses.
- Effective surgical treatments were employed with minimal long-term sequelae.