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    Korean J Urol. 2006 Jun;47(6):651-655. Korean.
    Published online Jun 30, 2006.
    https://doi.org/10.4111/kju.2006.47.6.651
    Copyright © 2006 The Korean Urological Association
    Original Article

    Urachal Anomalies in Children: A Proper Approach and Treatment Based on the Recent Ten-year Experience

    Byung Joo Jung, Jeong Min Seo,1 Suk Koo Lee,1 and Kwan Hyun Park
      • Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
      • 1Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
    • Corresponding author (Email: khpark@smc.samsung.co.kr )
    Received February 07, 2006; Accepted April 18, 2006.

    Abstract

    Purpose

    To establish the proper approach and management of an urachal anomaly in children.

    Materials and Methods

    We retrospectively reviewed the medical records and imaging studies of 33 children (21 boys, 12 girls) treated for an urachal anomaly over a ten-year period.

    Results

    Twenty-four patients were equally diagnosed with either an urachal sinus or urachal cyst; the other nine patients were confirmed to have a patent urachus. Umbilical discharge (14 patients) and umbilical granuloma (9 patients) were the most common presentations. The 12 patients with an urachal sinus underwent ultrasonography (USG) (10; diagnostic), 2 fistulography (all; diagnostic). Those with an urachal cyst underwent either USG (6/12; diagnostic), computed tomography (CT) (3; diagnostic), fistulography (2; diagnostic), or magnetic resonance imaging (MRI) (1; diagnostic). One subject was affected by acute appendicitis, which was confirmed by CT. Of the 9 children with patent urachus, 7 underwent USG (all; diagnostic); exploration without further imaging studies was performed on the remaining 2 subjects. Surgical excision was performed in 30 patients. Omphalomesenteric duct or Meckel's diverticulum were incidental findings, which were simultaneously repaired. Conservative treatment was successful in only 3 patients.

    Conclusions

    Urachal anomalies in children mainly manifest as umbilical discharges and umbilical granuloma, but may present non-specific symptoms in some cases. USG is a useful method for diagnosis, but other imaging modalities can be useful to establish the differential diagnosis. A limited number of children with urachal anomalies, mainly presenting with an umbilical discharge, can be managed conservatively. However, complete surgical excision of the lesion, with the possible associated anomalies, should be the basic scheme for children with urachal anomalies.

    Keywords
    Urachus; Anomalies; Children; Diagnosis; Treatment

    Figures

    Fig. 1
    Presenting symptoms of the children with urachal anomalies.

    Tables

    Table 1
    Presenting symptoms of the children with various forms of urachal anomalies

    Table 2
    Diagnostic approaches for the children with urachal anomalies

    Table 3
    Management and associated anomalies for the children with urachal anomalies

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    MeSH Terms
    Appendicitis
    Child*
    Diagnosis
    Diagnosis, Differential
    Granuloma
    Humans
    Incidental Findings
    Magnetic Resonance Imaging
    Meckel Diverticulum
    Medical Records
    Retrospective Studies
    Ultrasonography
    Urachal Cyst
    Urachus
    Vitelline Duct
    Metrics
    Share
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    Tables
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