21/83. Pseudocyst of the umbilical cord with mucoid degeneration of Wharton's jelly. The perinatal findings of a pregnancy complicated by an umbilical cord abnormality associated with mucoid degeneration of Wharton's jelly are presented. Serial ultrasound examinations were not performed because the patient did not visit our outpatient department regularly. The umbilical cord cyst was not detected on ultrasound until delivery. ( info) |
22/83. Laparoscopic radical excision of urachal sinus. Persistent urachus is a rare congenital anomaly. Various types of remnants have been described including cyst, alternating sinus, patent urachus, diverticulum, and sinus. The most common presenting symptom of urachal sinus is umbilical discharge. Radical excision of the remnant, with or without a bladder cuff, is essential to prevent future malignant degeneration or recurrence of the remnant. Although open surgical excision has been the treatment of choice for many years, the laparoscopic approach has become an attractive alternative because of its association with less postoperative pain, better cosmesis, and rapid convalescence. Laparoscopic radical excision of a urachal sinus was performed in a 16-year-old female patient who presented with umbilical discharge. ( info) |
23/83. Urachal abscesses: protean manifestations, their recognition, and management. We present the manifestations, their recognition, and treatment of urachal disorders, as well as report on 3 cases of urachal abscess in children. A review of the English literature is included. ( info) |
| umbilical cord anomalies can often be detected prenatally by ultrasound, but a definitive prenatal diagnosis is not always possible. We present a case with increasing edema of the Wharton's jelly followed by the development of pseudocysts in the proximal umbilical cord due to a patent urachus. The first abnormal findings were detected by ultrasound in the 14th week of gestation. Differential diagnoses and their influence on surveillance and birth management are discussed. ( info) |
25/83. Acute presentation of infected urachal cysts: case report and review of diagnosis and therapeutic interventions. Urachal remnants, although relatively rare, masquerade as a large number of diverse disorders leading to a high rate of misdiagnosis. A typical case is reported in which a 10-year-old boy presented to the Emergency Department twice before being incorrectly diagnosed with a pelvic or lower abdominal periappendiceal abscess. Definitive diagnosis and treatment of an infected urachal cyst were made intraoperatively. A review and discussion of urachal remnants is presented, and a diagnostic algorithm and treatment plan is offered for this entity. ( info) |
| Allantoic cysts of umbilical cord are very rare. A preterm, low birth weight, male newborn with a new constellation of anomalies, allantoic duct cysts in the umbilical cord and associated perinatally lethal malformations of VACTERL sequence, is reported. In addition, the neonate also had duodenal atresia, patent urachus, obstructive uropathy and bifid scrotum. association of Allantoic cysts with VACTERL sequence has not been described earlier. ( info) |
27/83. Urachal inflammatory myofibroblastic tumor with ALK gene rearrangement: a study of urachal remnants. OBJECTIVES: Abnormalities of the urachus are rare among children and include a patent tract and cyst formation. These structures can also be affected by infection and abscess development. They are usually diagnosed during infancy and treated by surgical resection. Involvement of this remnant by either benign or malignant tumors is very infrequent. A few cases of mesenchymal tumors, such as desmoid tumor and leiomyoma, involving the urachus have been described in published reports. methods: We studied an inflammatory myofibroblastic tumor arising from the urachus in a 10-year-old boy. In addition, we reviewed 101 cases of urachal remnants retrieved from the surgical pathology and autopsy files in the Department of pathology at the Children's Hospital boston diagnosed in the past 82 years. RESULTS: The urachal inflammatory myofibroblastic tumor showed anaplastic lymphoma kinase (ALK) rearrangement by immunohistochemistry and fluorescence in situ hybridization techniques. No other neoplasms were diagnosed in the analyzed population. CONCLUSIONS: We describe an example of inflammatory myofibroblastic tumor involving the urachus. Involvement of the urachus by tumors is rare, but these should be considered in the differential diagnosis of urachal lesions. ( info) |
28/83. Renal failure as a result of mesenteric cyst. The authors report a rare case of renal failure secondary to abdominal cyst in a newborn girl. The clinical presentation was one of a largely distended abdomen coupled with anuria. The histopathologic and clinical findings suggest mesenteric cyst causing renal failure by mass effect. ( info) |
29/83. Large pseudocyst of the umbilical cord associated with patent urachus. Cystic masses of the umbilical cord have been detected in the second and third trimesters of pregnancy in association with fetal abdominal wall defects and chromosomal anomalies. We present a case of an umbilical cord pseudocyst diagnosed using routine ultrasound at the 20 weeks of gestation. Serial sonography followed the progression of the cystic masses. A 2960-g male infant was delivered at term, in whom a patent urachus was detected. The infant underwent repair with closure of the patent urachus and plastic reconstruction of the abdominal wall, and the postoperative course was uneventful. This case demonstrated an uneventful outcome despite the persistent multiple cord cysts. ( info) |
| urachal cyst is rather a rare lesion with interesting and different ways of presentation. More urachal cysts are being shown by ultrasound and computed tomography, and their criteria for diagnosis are discussed. ( info) |