An urachus is a remnant of allantois in embryo development constituting a connection between the dome of the bladder and umbilicus. It develops on day 16 after conception and closes during the pregnancy to form the median umbilical ligament. Patent urachus results from a failure in closing its lumen in 10-12 gestational weeks. This anomaly occurs in 1-2 babies in 100,000 births. We present the case of patent urachus. In 20 gestational weeks, a dilatation of the umbilical cord with an anechoic mass with a transverse dimension of 19 x 12 mm starting from the fetal insertion and length of 30 cm was seen on ultrasound without any other fetal and placental disorders. Histology showed cystic edema. Prenatal diagnosis of patent urachus can be difficult because this pathology may be mistaken with other, more dangerous causes of cord cysts; thus, the occurrence of cord cysts should be closely monitored.

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http://dx.doi.org/10.5603/GP.a2021.0156DOI Listing

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  • - Two congenital anomalies were identified in an infant, involving the umbilicus, including a mass present since birth and a patent urachus observed during a cystourethrogram.
  • - During surgical exploration, a patent vitellointestinal duct was discovered alongside the urachus, leading to surgical resection and anastomosis of the duct, while the urachus was excised.
  • - Histopathological analysis revealed intestinal epithelium in the duct and a dense fibrous structure in the urachus, with a cautionary note about the proximity of omphalo-mesenteric vessels during surgery to avoid excessive bleeding.
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  • Urachal abnormalities are rare conditions caused by the incomplete closure of the urachal canal, leading to a persistent fibrous structure.
  • The diagnosis can begin with ultrasound but is typically confirmed through computed tomography (CT).
  • Surgical excision is the recommended treatment to alleviate symptoms and prevent recurrence, as demonstrated by a 45-year-old man who had recurrent urinary tract infections and underwent laparoscopic surgery.
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