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Urachal Anomalies
Amir A. Borhani, MD; Michael P. Federle, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Definitions

            • Spectrum of anomalies due to incomplete obliteration of embryonic connection between bladder dome and allantoic duct
              • Patent urachus: Entire urachal channel fails to close
              • Urachal cyst: Umbilical and bladder openings close; channel in between remains open and fluid filled
              • Urachal sinus: Dilatation of urachus at umbilical end; no communication with bladder
              • Urachal diverticulum (a.k.a. urachal remnant): Dilatation of urachus at vesical end; no communication with umbilicus
            • Vestigial obliterated urachus, a.k.a. median umbilical ligament

          IMAGING

          • General Features

            • Radiographic Findings

              • Fluoroscopic Findings

                • CT Findings

                  • Ultrasonographic Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Gleason JM et al: A comprehensive review of pediatric urachal anomalies and predictive analysis for adult urachal adenocarcinoma. J Urol. 193(2):632-6, 2015
                                        2. Metwalli ZA et al: Imaging features of intravesical urachal cysts in children. Pediatr Radiol. 43(8):978-82, 2013
                                        3. Yiee JH et al: A diagnostic algorithm for urachal anomalies. J Pediatr Urol. 3(6):500-4, 2007
                                        4. Wong-You-Cheong JJ et al: From the Archives of the AFIP: neoplasms of the urinary bladder: radiologic-pathologic correlation. Radiographics. 26(2):553-80, 2006
                                        5. Thali-Schwab CM et al: Computed tomographic appearance of urachal adenocarcinomas: review of 25 cases. Eur Radiol. 15(1):79-84, 2005
                                        6. Yu JS et al: Urachal remnant diseases: spectrum of CT and US findings. Radiographics. 21(2):451-61, 2001
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Clinical Issues

                                                TERMINOLOGY

                                                • Definitions

                                                  • Spectrum of anomalies due to incomplete obliteration of embryonic connection between bladder dome and allantoic duct
                                                    • Patent urachus: Entire urachal channel fails to close
                                                    • Urachal cyst: Umbilical and bladder openings close; channel in between remains open and fluid filled
                                                    • Urachal sinus: Dilatation of urachus at umbilical end; no communication with bladder
                                                    • Urachal diverticulum (a.k.a. urachal remnant): Dilatation of urachus at vesical end; no communication with umbilicus
                                                  • Vestigial obliterated urachus, a.k.a. median umbilical ligament

                                                IMAGING

                                                • General Features

                                                  • Radiographic Findings

                                                    • Fluoroscopic Findings

                                                      • CT Findings

                                                        • Ultrasonographic Findings

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                • Gross Pathologic & Surgical Features

                                                                  • Microscopic Features

                                                                    CLINICAL ISSUES

                                                                    • Presentation

                                                                      • Demographics

                                                                        • Natural History & Prognosis

                                                                          • Treatment

                                                                            DIAGNOSTIC CHECKLIST

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Gleason JM et al: A comprehensive review of pediatric urachal anomalies and predictive analysis for adult urachal adenocarcinoma. J Urol. 193(2):632-6, 2015
                                                                              2. Metwalli ZA et al: Imaging features of intravesical urachal cysts in children. Pediatr Radiol. 43(8):978-82, 2013
                                                                              3. Yiee JH et al: A diagnostic algorithm for urachal anomalies. J Pediatr Urol. 3(6):500-4, 2007
                                                                              4. Wong-You-Cheong JJ et al: From the Archives of the AFIP: neoplasms of the urinary bladder: radiologic-pathologic correlation. Radiographics. 26(2):553-80, 2006
                                                                              5. Thali-Schwab CM et al: Computed tomographic appearance of urachal adenocarcinomas: review of 25 cases. Eur Radiol. 15(1):79-84, 2005
                                                                              6. Yu JS et al: Urachal remnant diseases: spectrum of CT and US findings. Radiographics. 21(2):451-61, 2001