ABSTRACT
Urachal sinus is a congenital anomaly secondary to insufficiently high obliteration of the urachus. It can present clinically at any age with purulent umbilical discharge. A combination of ultrasound and fistulography is essential to confirm the diagnosis. There is a risk of adenocarcinomatous degeneration. Treatment consists of resection of the sinus and its implantation base on the bladder. Excision of the umbilicus is not mandatory in children. The authors report a retrospective analysis of 3 cases of urachal sinus in 3 girls with a mean age of 12 years, presenting a 3-month history of purulent umbilical discharge before admission. An umbilical nodule was detected in 2 patients and an infraumbilical spindle-shaped mass was observed in the third patient. Ultrasound showed an infraumbilical echogenic mass and fistulography, performed in 2 patients, showed a blind cavity directed inferiorly, confirming.the urachal sinus. Treatment consisted of complete resection of the sinus in one patient and complete resection of the sinus and its implantation base on the bladder in the other 2 patients. An associated teratoma of the right ovary was found in one patient. The postoperative course was uneventful. Umbilicoplasty, performed in 2 patients with resection of the umbilicus, was satisfactory. No recurrence was observed with a mean follow-up of 12 months. Histological examination did not reveal any signs of malignancy. Purulent umbilical discharge may indicate the presence or urachal sinus, which can be confirmed by a combination of ultrasound and fistulography. Treatment consists of resection of the sinus and its implantation base on the bladder. The objective of this study was to define the diagnostic and therapeutic features of urachal sinus.
