|ECR 2019 / C-2770|
|Imaging of Urachal remnant diseases|
Increasing use of radiological imaging has shown that urachal anomalies are now more common than previously thought. The spectrum of urachal anomalies includes a patent urachus, an umbilical-urachal sinus, a vesicourachal diverticulum and urachal cyst.
A patent urachus is an elongated patent connection between the bladder and the umbilicus. An umbilical-urachal sinus is depicted as a blind focal dilatation at the umbilical end, whereas a vesicourachal diverticulum is a focal outpouching at the vesical end. Urachal cysts are visualized as midline fluid-filled sacs most frequently located near the bladder dome. Complications include infection and tumours.
Urachal anomalies are often recognised and managed in childhood. However persistence in to adulthood has an increased risk of morbidity and mortality. The management of urachal anomalies is controversial with no clear guidelines. Currently, treatment is based on age and symptoms with a more conservative approach preferred in children and surgical excision preferred in symptomatic adults.