Urachal cyst
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View Mohammad Taghi Niknejad's current disclosures- Urachal cysts
Urachal cysts are one of the manifestations of the spectrum of congenital urachal remnant abnormalities.
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Epidemiology
An infected urachal cyst can occur at any age.
Clinical presentation
Urachal cysts usually remain asymptomatic until complicated by infection or bleeding.
Pathology
Urachal cysts form when both the umbilical and vesical ends of the urachal lumen close while an intervening portion remains patent and fluid-filled. The cyst can drain through the umbilicus, bladder, or through the peritoneum and into intraperitoneal organs. Rarely it can cause peritonitis and abdominal symptoms.
The most common pathogens of urachal abscess are Staphylococcus, E. coli, Pseudomonas, and Streptococcus.
Radiographic features
An uncomplicated urachal cyst appears as a collection of simple fluid localized in the midline of the anterior abdominal wall, between the umbilicus and the pubis and often contiguous with the bladder dome.
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Treatment and prognosis
Treatment of a urachal cyst may involve IV antibiotic therapy and/or surgical excision. Drainage is usually associated with a high rate of relapse. Sometimes it is advisable to drain the cyst contents before its excision.
Differential diagnosis
For an infected urachal cyst, bladder adenocarcinoma should be considered. For a non-infected urachal cyst general imaging differential considerations include
References
- 1. Berrocal T, López-pereira P, Arjonilla A et-al. Anomalies of the distal ureter, bladder, and urethra in children: embryologic, radiologic, and pathologic features. Radiographics. 22 (5): 1139-64. Radiographics (full text) - Pubmed citation
- 2. Yu JS, Kim KW, Lee HJ et-al. Urachal remnant diseases: spectrum of CT and US findings. Radiographics. 21 (2): 451-61. Radiographics (full text) - Pubmed citation
- 3. Pesce C, Costa L, Musi L, Campobasso P, Zimbardo L. Relevance of infection in children with urachal cysts. (2000) European urology. 38 (4): 457-60. doi:10.1159/000020324 - Pubmed
- 4. Navarrete S, Sánchez Ismayel A, Sánchez Salas R, Sánchez R, Navarrete Llopis S. Treatment of urachal anomalies: a minimally invasive surgery technique. (2005) JSLS : Journal of the Society of Laparoendoscopic Surgeons. 9 (4): 422-5. Pubmed
- 5. Chauvin N, Domachowske JB. Infected urachal cyst presenting as fever of unknown origin. (2005) Clinical pediatrics. 44 (1): 85-7. doi:10.1177/000992280504400111 - Pubmed
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