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Urachal Anomalies
Kyle K. Jensen, MD; Amir A. Borhani, MD
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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: Patency of urachus at umbilical end; no communication with bladder
              • Urachal diverticulum (i.e., urachal remnant): Patency of urachus at bladder end; no communication with umbilicus
            • Vestigial obliterated urachus = median umbilical ligament

          IMAGING

          • General Features

            • Radiographic Findings

              • Fluoroscopic Findings

                • CT Findings

                  • MR 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. Das JP et al: The urachus revisited: multimodal imaging of benign & malignant urachal pathology. Br J Radiol. 93(1110):20190118, 2020
                                          2. Buddha S et al: Imaging of urachal anomalies. Abdom Radiol (NY). 44(12):3978-89, 2019
                                          3. 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
                                          4. Wassef SN et al: Infected urachal cyst. Ultrasound Q. 31(3):210-1, 2015
                                          5. Metwalli ZA et al: Imaging features of intravesical urachal cysts in children. Pediatr Radiol. 43(8):978-82, 2013
                                          6. Yiee JH et al: A diagnostic algorithm for urachal anomalies. J Pediatr Urol. 3(6):500-4, 2007
                                          7. 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
                                          8. Thali-Schwab CM et al: Computed tomographic appearance of urachal adenocarcinomas: review of 25 cases. Eur Radiol. 15(1):79-84, 2005
                                          9. 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: Patency of urachus at umbilical end; no communication with bladder
                                                      • Urachal diverticulum (i.e., urachal remnant): Patency of urachus at bladder end; no communication with umbilicus
                                                    • Vestigial obliterated urachus = median umbilical ligament

                                                  IMAGING

                                                  • General Features

                                                    • Radiographic Findings

                                                      • Fluoroscopic Findings

                                                        • CT Findings

                                                          • MR 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. Das JP et al: The urachus revisited: multimodal imaging of benign & malignant urachal pathology. Br J Radiol. 93(1110):20190118, 2020
                                                                                  2. Buddha S et al: Imaging of urachal anomalies. Abdom Radiol (NY). 44(12):3978-89, 2019
                                                                                  3. 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
                                                                                  4. Wassef SN et al: Infected urachal cyst. Ultrasound Q. 31(3):210-1, 2015
                                                                                  5. Metwalli ZA et al: Imaging features of intravesical urachal cysts in children. Pediatr Radiol. 43(8):978-82, 2013
                                                                                  6. Yiee JH et al: A diagnostic algorithm for urachal anomalies. J Pediatr Urol. 3(6):500-4, 2007
                                                                                  7. 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
                                                                                  8. Thali-Schwab CM et al: Computed tomographic appearance of urachal adenocarcinomas: review of 25 cases. Eur Radiol. 15(1):79-84, 2005
                                                                                  9. Yu JS et al: Urachal remnant diseases: spectrum of CT and US findings. Radiographics. 21(2):451-61, 2001