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Pediatrics
Diagnosis
Genitourinary
Congenital Urinary Tract Abnormalities
Urachal Abnormalities
Urachal Abnormalities
Sara M. O'Hara, MD, FAAP
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        TERMINOLOGY

        • Synonyms

          • Patent urachus, urachal fistula, urachal remnant, urachal cyst, urachal sinus, urachal diverticulum

        • Definitions

          • Partial or complete persistence of connection between bladder dome & umbilicus; remnant of fetal allantoic stalk

        IMAGING

        • General Features

          • Radiographic Findings

            • Fluoroscopic Findings

              • Ultrasonographic Findings

                • CT Findings

                  • MR Findings

                    • Nuclear Medicine Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        Selected References

                                        1. De Marco EA et al: Incidental diagnosis of giant cell tumor after urachal remnant removal in a thalassemic child. Urology. 90:170-2, 2016
                                        2. Hsieh TC et al: A mimic of intra-abdominal malignancy: physiological urinary excretion of FDG in the rare adult vesicourachal diverticulum. Clin Nucl Med. 41(6):466-8, 2016
                                        3. Stopak JK et al: Trends in surgical management of urachal anomalies. J Pediatr Surg. 50(8):1334-7, 2015
                                        4. Metwalli ZA et al: Imaging features of intravesical urachal cysts in children. Pediatr Radiol. 43(8):978-82, 2013
                                        5. Naiditch JA et al: Current diagnosis and management of urachal remnants. J Pediatr Surg. 48(10):2148-52, 2013
                                        6. Giuliani S et al: Prune belly syndrome associated with cloacal anomaly, patent urachal remnant, and omphalocele in a female infant. J Pediatr Surg. 45(11):e39-42, 2010
                                        7. Lamb BW et al: Mucinous adenocarcinoma of the urachal remnant with pseudomyxoma peritonei. Urol J. 7(2):138-9, 2010
                                        8. Copp HL et al: Clinical presentation and urachal remnant pathology: implications for treatment. J Urol. 182(4 Suppl):1921-4, 2009
                                        9. Hernandez DM et al: Persistence of an infected urachus presenting as acute abdominal pain. Case report. Arch Esp Urol. 62(7):589-92, 2009
                                        10. Iwasaki M et al: Umbilical cyst containing ectopic gastric mucosa originating from an omphalomesenteric duct remnant. J Pediatr Surg. 44(12):2399-401, 2009
                                        11. Galati V et al: Management of urachal remnants in early childhood. J Urol. 180(4 Suppl):1824-6; discussion 1827, 2008
                                        12. Al-Omar O et al: Continent urinary diversion with a urachal remnant. J Pediatr Urol. 1(5):361-3, 2005
                                        13. Nobuhara KK et al: The giant umbilical cord: an unusual presentation of a patent urachus. J Pediatr Surg. 39(1):128-9, 2004
                                        14. Ozel SK et al: An unusual presentation of patent urachus: report of a case. Eur J Pediatr Surg. 14(3):206-8, 2004
                                        15. Amano Y et al: MR imaging of umbilical cord urachal (allantoic) cyst in utero. AJR Am J Roentgenol. 180(4):1181-2, 2003
                                        16. McCollum MO et al: Surgical implications of urachal remnants: Presentation and management. J Pediatr Surg. 38(5):798-803, 2003
                                        17. Ueno T et al: Urachal anomalies: ultrasonography and management. J Pediatr Surg. 38(8):1203-7, 2003
                                        18. Cothren C et al: Urachal carcinoma: key points for the general surgeon. Am Surg. 68(2):201-3, 2002
                                        19. Yu JS et al: Urachal remnant diseases: spectrum of CT and US findings. Radiographics. 21(2):451-61, 2001
                                        20. Clapuyt P et al: Urachal neuroblastoma: first case report. Pediatr Radiol. 29(5):320-1, 1999
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Clinical Issues

                                              TERMINOLOGY

                                              • Synonyms

                                                • Patent urachus, urachal fistula, urachal remnant, urachal cyst, urachal sinus, urachal diverticulum

                                              • Definitions

                                                • Partial or complete persistence of connection between bladder dome & umbilicus; remnant of fetal allantoic stalk

                                              IMAGING

                                              • General Features

                                                • Radiographic Findings

                                                  • Fluoroscopic Findings

                                                    • Ultrasonographic Findings

                                                      • CT Findings

                                                        • MR Findings

                                                          • Nuclear Medicine Findings

                                                            • Imaging Recommendations

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  • Gross Pathologic & Surgical Features

                                                                    • Microscopic Features

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              Selected References

                                                                              1. De Marco EA et al: Incidental diagnosis of giant cell tumor after urachal remnant removal in a thalassemic child. Urology. 90:170-2, 2016
                                                                              2. Hsieh TC et al: A mimic of intra-abdominal malignancy: physiological urinary excretion of FDG in the rare adult vesicourachal diverticulum. Clin Nucl Med. 41(6):466-8, 2016
                                                                              3. Stopak JK et al: Trends in surgical management of urachal anomalies. J Pediatr Surg. 50(8):1334-7, 2015
                                                                              4. Metwalli ZA et al: Imaging features of intravesical urachal cysts in children. Pediatr Radiol. 43(8):978-82, 2013
                                                                              5. Naiditch JA et al: Current diagnosis and management of urachal remnants. J Pediatr Surg. 48(10):2148-52, 2013
                                                                              6. Giuliani S et al: Prune belly syndrome associated with cloacal anomaly, patent urachal remnant, and omphalocele in a female infant. J Pediatr Surg. 45(11):e39-42, 2010
                                                                              7. Lamb BW et al: Mucinous adenocarcinoma of the urachal remnant with pseudomyxoma peritonei. Urol J. 7(2):138-9, 2010
                                                                              8. Copp HL et al: Clinical presentation and urachal remnant pathology: implications for treatment. J Urol. 182(4 Suppl):1921-4, 2009
                                                                              9. Hernandez DM et al: Persistence of an infected urachus presenting as acute abdominal pain. Case report. Arch Esp Urol. 62(7):589-92, 2009
                                                                              10. Iwasaki M et al: Umbilical cyst containing ectopic gastric mucosa originating from an omphalomesenteric duct remnant. J Pediatr Surg. 44(12):2399-401, 2009
                                                                              11. Galati V et al: Management of urachal remnants in early childhood. J Urol. 180(4 Suppl):1824-6; discussion 1827, 2008
                                                                              12. Al-Omar O et al: Continent urinary diversion with a urachal remnant. J Pediatr Urol. 1(5):361-3, 2005
                                                                              13. Nobuhara KK et al: The giant umbilical cord: an unusual presentation of a patent urachus. J Pediatr Surg. 39(1):128-9, 2004
                                                                              14. Ozel SK et al: An unusual presentation of patent urachus: report of a case. Eur J Pediatr Surg. 14(3):206-8, 2004
                                                                              15. Amano Y et al: MR imaging of umbilical cord urachal (allantoic) cyst in utero. AJR Am J Roentgenol. 180(4):1181-2, 2003
                                                                              16. McCollum MO et al: Surgical implications of urachal remnants: Presentation and management. J Pediatr Surg. 38(5):798-803, 2003
                                                                              17. Ueno T et al: Urachal anomalies: ultrasonography and management. J Pediatr Surg. 38(8):1203-7, 2003
                                                                              18. Cothren C et al: Urachal carcinoma: key points for the general surgeon. Am Surg. 68(2):201-3, 2002
                                                                              19. Yu JS et al: Urachal remnant diseases: spectrum of CT and US findings. Radiographics. 21(2):451-61, 2001
                                                                              20. Clapuyt P et al: Urachal neuroblastoma: first case report. Pediatr Radiol. 29(5):320-1, 1999