Carcinoma del uraco / Urachal Carcinoma

Objetivo Revisar la patología tumoral del uraco, haciendo énfasis en su clínica, los métodos diagnósticos empleados y el manejo terapéutico. Métodos Presentamos el caso de un varón de 39 años con carcinoma del uraco que simuló clínicamente un absceso umbilical. Resultados Los hallazgos en la TC fueron sospechosos de patología del uraco. El examen anatomopatológico reveló células atípicas y la PET-TC demostró extensión a pared abdominal y epiplón, requiriéndose la resección completa. Conclusiones El carcinoma del uraco es una neoplasia muy poco frecuente, que tiene su origen en el epitelio que recubre la luz del uraco, un vestigio de la alantoides que conecta la vejiga con el ombligo y normalmente involuciona en la etapa embrionaria. La clínica insidiosa hace que el diagnóstico sea tardío y el pronóstico pobre. Las pruebas de imagen tienen un papel fundamental en su sospecha, así como en la definición de la relación con la pared vesical y posible extensión local o a distancia. Una vez confirmado el diagnóstico histológicamente, está indicada la resección quirúrgica completa.

Objective To review tumoral pathology of urachus, emphasizing its clinical manifestations, diagnostic methods and therapeutic management. Method We present the case of a 39-year-old male with urachal carcinoma who clinically mimicked an umbilical abscess. Result CT findings were suspected of urachus pathology. Histologic analysis of the resected specimen demonstrated atypical cells, and PET-CT showed extension to the abdominal wall and omentum, requiring complete resection. Conclusions Urachal carcinoma is a very rare neoplasm that originates in the epithelium that covers the lumen of the urachus, a vestige of the allantois that connects the bladder with the navel and normally involves in the embryonic stage. The insidious clinic makes late diagnosis and poor prognosis. Imaging tests play a fundamental role in their suspicion, as well as in the definition of the relationship with the bladder wall and possible local or distant extension. Once the diagnosis has been confirmed histologically, complete surgical resection is indicated.

Serum immunoglobulin from Nellore cattle produced by in vitro fertilization and treated for umbilical diseases / Imunoglobulinas séricas de bovinos Nelore produzidos por fertilização in vitro e tratados para onfalopatias

The aim of this study was to measure serum immunoglobulin concentrations of Nellore cattle produced by in vitro fertilization (IVF) with umbilical diseases and to evaluate surgical excision as a method of treatment. Sixteen cattle with ages ranging from 1 to 15 months, males and females, affected by umbilical diseases were enrolled in the study. Blood samples were collected for cell counts and the determination of immunoglobulin concentrations by electrophoresis and zinc sulphate turbidimetry (ZST). Four calves were presented with umbilical herniation, two with an umbilical herniation associated with a persistent urachus, two with an umbilical herniation with a persistent urachus and omphaloarteritis, three with an umbilical herniation and an urachal diverticulum, three with a persistent urachus, one with an urachal diverticulum, and one with omphalitis. The blood cell counts pre- and post-surgical revealed differences in cell volume and the number of leukocytes. The immunoglobulin values measured by electrophoresis values were below normal in most animals, whereas the ZST showed normal levels in most of them. Most of the calves affected by umbilical diseases and produced by IVF presented hypoglobulinaemia. Correlations between umbilical diseases, failure of passive transfer of immunity and IVF could not be demonstrated.(AU)

Os objetivos desse estudo foram mensurar as concentrações séricas das imunoglobulinas de bovinos Nelore, produzidos por fertilização in vitro (FIV), acometidos por onfalopatias e avaliar a excisão cirúrgica como método de tratamento. Utilizou-se 16 animais, com idade variando de 1 a 15 meses, machos e fêmeas, acometidos por afecções umbilicais. Amostras de sangue foram colhidas para realização de hemogramas e avaliação das imunoglobulinas, por meio de eletroforese e turbidimetria com sulfato de zinco. Foram observados quatro casos de hérnias umbilicais, dois de hérnia umbilical associadas à persistência de úraco, dois casos de hérnia umbilical com persistência de úraco e onfaloarterite, três de hérnia umbilical com divertículo de úraco, três casos de persistência de úraco, um de divertículo de úraco e um de onfalite. O hemograma revelou diferença significativa para os valores de Volume Globular e Leucócitos, nos momentos pré e pós-tratamento cirúrgico dos animais. A eletroforese evidenciou valores de imunoglobulina abaixo da normalidade na maioria dos animais, enquanto que a turbidimetria apresentou níveis normais na maioria dos bovinos, quando comparados com valores de referência. A maioria dos bovinos estudados, acometidos de onfalopatias e concebidos por FIV, apresentaram hipoglobulinemia. Os resultados obtidos não permitem afirmar que existe relação entre as onfalopatias, falha de transferência de imunidade passiva e FIV.(AU)

Imperfuração congênita do óstio uretral externo associada à persistência de úraco em bezerra Nelore: relato de caso / Congenital external urethral ostium imperforation associated to urachal persistence in Nelore calf: case report

A imperfuração uretral associada ou não à persistência do úraco é rara; quando concomitante, o animal mantém o fluxo urinário por via umbilical, entretanto, após o tratamento de correção da persistência do úraco, ocorre o armazenamento de urina, que pode culminar em complicações como bexigoma, hidroureter e ruptura vesical. Uma bezerra Nelore, com 20 dias de idade, foi atendida com persistência de úraco. Prescreveu-se a aplicação local de tintura de iodo a 10% durante cinco dias, e indicou-se retorno para obliteração cirúrgica caso não houvesse resposta à terapia proposta. Após 30 dias, o animal retornou com distensão abdominal, histórico de diminuição gradual do fluxo urinário, com ausência de micção via vaginal e discreto gotejamento de urina através do umbigo. Após diversas tentativas de cateterismo uretral sem sucesso, diagnosticou-se a imperfuração do óstio uretral externo. O exame ultrassonográfico revelou distensão vesical com aproximadamente sete litros de conteúdo, hidroureter e hidronefrose bilateral. Realizou-se a cistocentese e o esvaziamento vesical guiado por ultrassom e optou-se pela abordagem cirúrgica para criação do óstio uretral e correção do úraco persistente. Por meio de cistotomia, realizou-se a sondagem retrógrada da uretra e a perfuração da membrana que recobria o óstio uretral no vestíbulo vaginal, a fim de criar um novo óstio. A sondagem foi mantida por 10 dias, com o intuito de evitar estenose do óstio e, após 30 dias de pós-operatório, o animal recebeu alta com óstio uretral patente no vestíbulo vaginal.(AU)

Urethral imperforation associated or not with urachal patency is rare, when concomitant, the animal maintains urinary flow through umbilical via, but when the treatment is performed storage of urine occurs and can culminate in complications like bexigoma, hydrourether, and vesical rupture. A nelore calf with 20 days of age, was attended with urachal patency, conservative treatment with searing substance (10% iodine) was prescribed. Return for surgical treatment was recommended if no resolution was achieved. After 30 days, the animal returned with abdominal distension and history of gradual decrease in urinary flow without urination via urethra. Urethral catheterization was attempted, unsuccessfully, and sonographic evaluation revealed vesical distention with approximately seven liters of content, hydrourether and hydronephrosis. cystocentesis and vesical deflation was performed. Surgical approach of the bladder was performed and a new ostium for the urethra in the vaginal vestibule was created by retrograde via. Urachal was removed and urethral catheterization was maintained for 10 days. Following 30 days of pos operative procedure, the animal was discharged.(AU)

Patología del ombligo / Pathology navel

El cordón umbilical, tan vital en la vida intrauterina, no tiene una función fisiológica en el ser humano después del nacimiento. Entre los primeros 10-20 días de vida del recién nacido requiere de cuidados que el pediatra y personal de salud que realiza los controles debe indicar a la madre para asegurar que el proceso de desecación y eliminación del cordón se complete de forma apropiada. Sin embargo, aun cuando la madre haya seguido correctamente las indicaciones, existen posibilidades de que la evolución clínica no sea la normal y la cicatrización se retarde o complique. Las posibilidades que el clínico debe sospechar son bastante variadas dentro de un espectro que va desde patologías leves hasta aquellas más complejas que incluyen alteraciones del desarrollo intrauterino con resultado de malformaciones congénitas. El propósito de este artículo es revisar la literatura publicada al respecto y actualizar aspectos clínicos importantes que el pediatra o médico que atiende niños debe conocer para orientar correctamente el diagnóstico y oportunidad terapéutica.

The umbilical cord, is a vital structure in utero, but it has no one physiological function in humans after birth. Among the first 10-20 days old newborn baby requires care pediatrician and health staff should learn to the mother how she must be care to make the drying process and complete removal of the cord can be appropriate. However, even if the mother has correctly followed the instructions, there are chances that the clinical course than the normal healing is delayed or complicated. The chances that the clinician should suspect are quite varied within a spectrum from mild to the most complex pathologies including disturbances of intrauterine development resulting in congenital malformations. The purpose of this article is to review the published literature and update important clinical aspects pediatrician or physician who treats children should learn to correctly orient the diagnosis and therapeutic opportunity.

Urachal Sinus Presenting with Periumbilicus Abscess / 대한소화기학회지

No abstract available.

Allantoic cyst and patent urachus.

Allantoic cysts of the umbilical cord are extremely rare anomalies. Only few cases have been reported in the postnatal life. The etiopathogenesis is still obscure. We describe a case of allantoic cyst and patent urachus in a newborn associated with hypospadias and meatal obstruction. We also present the review of literature regarding this entity, embryology and etiopathogenesis.

Endometrial Stromal Sarcoma Presenting as Prevesical Mass Mimicking Urachal Tumor

Endometrial stromal sarcoma (ESS) is a mesenchymal neoplasm that usually occurs as a primary tumor of the uterine corpus, but rarely arises in other sites, such as the ovary, pelvic cavity, mesentery, omentum and intestine. Herein, we present a rare case of low-grade ESS presented as prevesical mass. A 60-yr-old woman who had undergone total hysterectomy for endometriosis eleven years ago was presented with incidentally detected prevesical pelvic mass. Since malignant transformation of urachal remnants was possible, the mass was suspected to be a urachal tumor. Extraction of the mass was performed, and the histopathologic diagnosis was low-grade ESS. In summary, prevesical tumor is rare but in patients with endometriosis, we suggest endometriosis and its possible malignant changes should be taken into account in the differential diagnosis of prevesical mass.

Umbilical perforation: a rare complication of entriculoperitoneal shunt

A female baby of one-and-a-half-year old presented with extrusion of ventriculoperitoneal [VP] shunt through umbilicus. On exploration, the urachal remnant was found perforated by VP shunt and the tube exteriorized through umbilicus. Child was managed successfully with excision of urachal remnant, removal of VP shunt, antibiotic treatment and re-insertion of shunt

Persistência do uraco em gato: relato de caso / Urachal persistence in a cat: case report

Relata-se o caso de um gato que apresentava persistência do uraco, cujos principais sinais clínicos, iniciados apenas aos cinco meses de idade foram micção através da cicatriz umbilical, hiperemia da área circunvizinha e presença de uma fístula no centro do umbigo. A afecção foi diagnosticada mediante exames clínico, laboratorial, ultra-sonográfico e radiográfico, especialmente pela cistografia

It is reported a case of a cat presenting persistence of the urachal. The symptoms only began at five months of age. The diagnosis was confirmed by the clinical, laboratorial, ultrasonographic and radiographic exams, especially by the cystography

Urachal Anomalies in Children: A Single Center Experience

The objective of this study is to define optimal diagnosis and treatment strategies for patients with urachal anomalies in the pediatric age group. The medical records of 21 children who had undergone surgery for urachal anomalies at Severance Hospital, Yonsei University College of Medicine from January 1990 to April 2005 were reviewed. The subjects included 14 males and 7 females (M:F 2:1). The four types of urachal anomalies confirmed were a urachal cyst in 10 patients (47.6%), a patent urachus in 6 (28.6%), a urachal sinus in 4 (19.0%) and a urachal diverticulum in 1 (4.8%) patient. The most common presenting complaint was umbilical discharge (n = 10, 40.0%), followed by abdominal mass (n = 9, 36.0%). Urachal anomalies were diagnosed by ultrasonography in 18 patients, and 7 of them were additionally examined by computed tomography. The remaining patients were diagnosed solely by surgical exploration. Excision was performed in all patients and was supplemented by partial cystectomy in three. Umbilical discharge was the most common clinical manifestation in our patients, suggesting that ultrasonography should be performed in patients with umbilical discharge to differentiate urachal anomalies. We found the most common anomaly to be the urachal cyst, and all patients were successfully treated by surgical excision.

Laparoscopic Management of Complicated Urachal Remnant in a Child

A few cases of laparoscopic surgery for urachal remnant in children has been reported in English literature. With recent developments in minimal invasive surgery, laparoscopic approach for urachal remnant in adulthood is recommended by some laparoscopic surgeons because of its technical feasibility and safety as well as cosmesis. Recently we experienced a case of complicated urachal remnant in a 14-month-old girl, who was managed by laparoscopic approach. At presentation, she complained of high fever and lower urinary tract symptoms. After 6 weeks of antibiotics therapy, laparoscopic surgery was performed transperitoneally via 3 ports. Our experience suggests that laparoscopic excision of urachal remnant can be performed easily and safely in children.

Seio uracal em adulto / Urachal sinus in adult

Os autores apresentam um caso de seio uracal em adulto, patologia rara nesta faixa etária, e revisam os aspectos embriológicos e anatômicos do úraco, evidenciando sua apresentaçao clínica, evoluçao e terapêutica.

Anomalías del uraco: informe de 10 casos / Abnirmalities of the urachus: report of ten cases

Las anomalías del uraco son raras y generalmente se manifiestan en la infancia. La presentación sintomática en el adulto es todavía menos frecuente, y en la literatura mundial se han informado sólo unos 370 casos. En este artículo se presentan diez casos de anomalías del uraco en edad pediátrica: cuatro quistes, cinco uracos permeables y una extensión uracal. Se revisa la embriología de esta estructura única a conjunto para entender las anomalías del desarrollo, y se describen las cuatro variantes anatómicas del uraco normal, que son de gran utilidad para comprender las variaciones congénitas y el tratamiento quirúrgico establecido. Se realiza la presentación separada de los casos por su importancia y el escaso número de los mismos, haciendo énfasis en el tratamiento quirúrgico individualizado.

Uraco persistente em adulto / Persistent urachus in adult

Anormalidades do úraco em adultos säo incomuns. Os autores apresentam um caso de úraco persistente em edulto e fazem revisäo da embriologia e anatomia do úraco enfatizando apresentaçäo clínica, evoluçäo e tratamento.

Uraco permeavel / Patent urachus

O uraco permeavel e uma anomalia rara. Os autores apresentaram um caso em que e enfatizada a embriologia, sintomas clinicos, diagnostico e diagnostico diferencial do denominado "umbigo molhado".

Uraco patente com eversao de parede / Urachus patent eversion of wall

Os autores relatam dois casos de uraco patente com eversao de parede encaminhados a Clinica de Cirurgia Pediatrica no primeiro dia de vida com hipotese diagnostica de onfalocele. Revisam sumariamente a embriologia e as formas vestigiais do uraco, alertando sobre a importancia da investigacao de outras anomalias associadas. Assinalam, ainda, a necessidade do diagnostico e tratamento precoce chamando atencao para as patologias com as quais o diagnostico deferencial deve ser efetuado .