Umbilical-urachal sinus

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Umbilical-urachal sinus
File:Normal fully developed bladder with urachus and four of the most common urachal anomaly subtypes including patent urachus, vesicourachal diverticulum, urachal cyst, and umbilical-urachal.png
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Umbilical discharge, abdominal pain, infection
Complications	Infection, abscess formation
Onset	Neonatal or childhood
Duration	Chronic
Types	N/A
Causes	Congenital malformation of the urachus
Risks	Infection, urachal carcinoma (rare)
Diagnosis	Ultrasound, CT scan, MRI
Differential diagnosis	Patent urachus, urachal cyst, omphalitis
Prevention	N/A
Treatment	Surgical excision
Medication	Antibiotics for infection
Prognosis	Good with treatment
Frequency	Rare
Deaths	N/A

An umbilical-urachal sinus is a type of urachal anomaly, which is a developmental defect of the urachus, a remnant of the embryonic connection between the bladder and the umbilicus. During fetal development, the urachus is a tubular structure that usually obliterates and becomes the median umbilical ligament. However, if this process is incomplete, various urachal anomalies can occur, including the formation of an umbilical-urachal sinus.

Anatomy and Development

The urachus is a fibrous remnant of the allantois, which is involved in early fetal development. It extends from the anterior dome of the bladder to the umbilicus. Normally, the urachus obliterates and forms a fibrous cord known as the median umbilical ligament. In some cases, the urachus fails to close completely, leading to different types of urachal anomalies, such as a patent urachus, urachal cyst, vesicourachal diverticulum, and umbilical-urachal sinus.

Pathophysiology

An umbilical-urachal sinus occurs when the urachus remains open at the umbilical end but is closed at the bladder end. This results in a blind-ending tract that can become infected or discharge fluid through the umbilicus. The sinus may present with symptoms such as umbilical discharge, redness, or swelling.

Diagnosis

Diagnosis of an umbilical-urachal sinus typically involves imaging studies such as ultrasound, which can reveal the presence of a sinus tract. Other imaging modalities, such as a voiding cystourethrogram (VCUG) or computed tomography (CT) scan, may be used to further evaluate the anatomy and rule out other conditions.

Treatment

The treatment of an umbilical-urachal sinus usually involves surgical excision of the sinus tract. This is often performed to prevent recurrent infections and to eliminate the risk of potential complications. The procedure involves removing the sinus tract and any associated fibrous tissue.

See Also

• Urachal anomalies
• Patent urachus
• Urachal cyst
• Vesicourachal diverticulum