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Urachal remnant causing umbilical in-drawing during micturition

Lookup NU author(s): Dr Alexander MartinORCiD, Dr Leigh McDonald, Milan Gopal

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Abstract

The urachus is a vestigial remnant of the allantois, which is normally obliterated during fetal life to become the median umbilical ligament, which runs between the urinary bladder and umbilicus in adults. Failure of obliteration leaves a tubular urachal remnant, which may present with disease. We report a unique case of a urachal remnant causing umbilical pain and in-drawing on micturition in a nine-year-old boy. There was no urine discharge from the umbilicus and in-drawing did not occur on defecation. His urinary stream was normal. High frequency ultrasonography revealed a thick band with a narrow, anechoic, fluid filled central channel. Exploration via an infraumbilical curvilinear incision identified a thick urachal band that could be traced to the dome of the bladder. This was excised flush with the bladder. The patient remains well at nine months following surgery with complete cessation of symptoms.

Publication metadata

Author(s): Martin AJ, McDonald L, Gopal M

Publication type: Article

Publication status: Published

Journal: Annals of the Royal College of Surgeons of England

Year: 2018

Volume: 100

Issue: 2

Pages: e31-e33

Print publication date: 01/02/2018

Online publication date: 28/11/2017

Acceptance date: 02/04/2016

ISSN (print): 0035-8843

ISSN (electronic): 1478-7083

Publisher: Royal College of Surgeons of England

URL: https://doi.org/10.1308/rcsann.2017.0197

DOI: 10.1308/rcsann.2017.0197

PubMed id: 29181994

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