Complicated urachal remnant
Non-specific abdominal pain. No further history provided. Unfortunately, the patient is lost to follow up.
Multi-phase abdomen and pelvis CT scan
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There is a thick enhancing wall lesion that arises / is inseparable from the urinary bladder dome, tapering up to the umbilicus region. Fluid intensity material is seen within the lesion. A thick enhancing septum is also seen. The inside wall is nodular and enhancing. The surrounding fat planes are congested.
The urinary bladder has an abnormally thickened wall and enhancing mucosa.
Of note are left sided benign looking adnexal cyst and a few gallstones.
The sagittal reformation better shows the anatomical relations.
The delayed phase indirectly adds that this lesion is not connected to the urinary bladder.
A patent urachus is one of the spectra of the congenital urachal remnant abnormalities. Although a patent urachus is a benign entity per se, it can be brought to attention if it gets complicated by infection, or the more sinister pathology; adenocarcinoma.