Sonographic detection of an infected maternal urachal cyst during pregnancy.

Infection of a maternal urachal cyst during pregnancy is rare; Sonography is an important diagnostic tool that can help minimize maternal and fetal complications. We describe the case of a 35-year-old multiparous woman presenting in the third trimester with 2 weeks of fever, abdominal pain, and urinary symptoms. Imaging showed a 5-cm complex anterior midline mass, found intraoperatively to be eroding into the uterus. Sonographic imaging aided in the diagnosis and management of the urachal cyst, and antepartum sonographic measurements of the lower uterine segment helped to counsel regarding a trial of labor. Following treatment, the patient stabilized and had an uncomplicated vaginal delivery.

Successful treatment of a patient with an infected urachal remnant via single-incision laparoscopic surgery: Report of a case.

We report on a case of an infected urachal remnant successfully treated via a single-incisional laparoscopic technique. An 18-year-old woman was diagnosed with an infected urachal remnant. The center of the umbilicus was pulled and inverted from the skin, and the cephalic side of the urachus was dissected from the umbilicus. A single-incision laparoscopic technique employing ultrasonic coagulating shears was used to dissect the urachal remnant from the stump of the umbilicus to the caudal end. Single-incision laparoscopic excision of the urachal remnant can be used successfully as a minimally invasive technique with optimal cosmetic outcomes.

Laparoscopic radical excision of urachal remnants with recurrent infection in infants.

PURPOSE: To evaluate the usefulness of laparoscopic surgery in the management of urachal remnants with recurrent infection in infants. PATIENTS AND METHODS: Eight infants (mean age 9.6 months, range 2-16 months) underwent laparoscopic excision of urachal remnants with recurrent infection between June 2006 and December 2008. During the same period, 10 infants (mean age 13.2, range 4-17 months) underwent open surgery for the same condition. The laparoscopic surgery was performed transperitoneally by using three ports. The urachal remnant was dissected from the umbilicus to the bladder dome and then removed completely. RESULTS: Immediate complications did not develop in any patient. Blood loss, hospital stay, and operative time with laparoscopic surgery were less than those with open surgery. Recurrence did not develop in any patient who underwent laparoscopic surgery, while it did develop in one patient who underwent open surgery. CONCLUSION: The laparoscopic approach appears to be a safe and effective alternative to open surgery in the management of urachal remnants with recurrent infection in infants.

[Actinomycosis in persistent urachus]. / Promienica w przetrwalym moczowniku.

A 70 -year old woman with tumor of urachus confirmed in USG and CT us described in this article. In this tumor we have found during histopathology Gram-positive Actinomyceces. The location of Actinomyces in urachus is very rare.

Infection of internal umbilical remnant in foals by Clostridium sordellii.

Omphalitis and the resulting septicemia contribute to perinatal mortality in several animal species. In foals, the most important causes of omphalitis are Escherichia coli and Streptococcus zooepidemicus. However to date, no information has been published about the role of Clostridium sordellii in these infections. In this paper, we describe 8 cases of perinatal mortality in foals associated with internal umbilical remnant infection by C. sordellii. The foals studied were between 12 and 21 days old at the time of death, and various breeds were represented in the group. Five of the foals were male and 3 were female. The diagnosis was established on the basis of the detection of C. sordellii by 3 methods (culture, fluorescent antibody test, and immunohistochemistry) and on gross and histopathologic findings. All foals had acute peritonitis, and the internal umbilical remnant was thickened by edema, hemorrhage, and fibrosis. A moderate amount of serosanguinous fluid with fibrin strands was present in the pericardial sac and pleural cavity. Histopathologically, the urachus and umbilical arterial walls were thickened by edema and exhibited hemorrhage, fibrin, and leukocytic infiltration. Gram-positive bacterial rods were observed in subepithelial areas of the urachus, the adventicia of umbilical arteries, and interstitium of the internal umbilical remnant. On the basis of these findings, we suggest that C. sordellii should be considered in the differential diagnosis for infections of the internal umbilical remnant in foals.

Patent urachus with subsequent joint infection in a free-living Grevy's zebra foal.

A free-living, female Grevy's zebra (Equus grevyi) foal was found lethargic, lame, with swollen joints, pyrexia, and urine dripping from the umbilicus. It died 2 days later despite intensive care. Gross examination revealed patent urachus and suppurative arthritis. Swabs were taken from the joints, the patent urachus, and urine for bacteriology. The dominant isolate was Escherichia coli. The joint infection was probably secondary to septicemia, resulting from the patent urachus. To our knowledge, this is the first report of neonatal patent urachus in a wild equid.

[Urachal actinomycosis: apropos of a case]. / Actinomicosis uracal: a propósito de un caso.

The report a new case of infected urachal cyst. The embryologic origin of the urachus, its anomalies, clinical features, diagnosis and treatment are discussed with the case of a 51 years old man who presented an hypogastric mass with the diagnosis of urachal actinomycosis.

Haemophilus somnus isolated from a urachal abscess in a calf.

A urachal abscess was diagnosed in a 2-month-old, crossbred heifer that was presented for a distended abdomen and clinical signs of choking. Cultures of the mucopurulent exudate, obtained from within the mass on necropsy, yielded Haemophilus somnus. This is the first known documented report of H. somnus isolated from a urachal abscess.

Laparoscopically assisted resection of umbilical structures in foals.

A technique for laparoscopically assisted resection of umbilical structures in foals was developed. Eleven foals ranging from 8 to 42 days old underwent this procedure. Results of bacteriologic culture of umbilical structures were positive in 7 foals. Mean duration of anesthesia was 99 minutes, of which the initial 20 to 25 minutes were typically devoted to positioning and preparation of the foal for surgery. Major complications did not develop in any foal. Minor complications, such as slippage of the endoscopic ligating clip or laceration of the bladder during dissection, were dealt with successfully during the procedure. Potential benefits of use of laparoscopy (i.e., decreased postoperative morbidity, smaller incisions, and increased intraoperative access to structures) must be carefully weighed against the risks of increased duration of anesthesia. However, anesthetic-related complications were not observed in any foal.

Actinomycosis of the urachus persistens penetrating into the ileum.

A 16-year-old boy is presented with the problem of free micturition, having a palpable, painless tumour spreading from the symphysis to the umbilicus. Cystoscopy revealed an impression in the vertex of the urinary bladder covered by the inflamed mucous membrane with a bulbar oedema. Fistulography showed transitional urachus persistens communicating with the terminal loops of the ileum. During surgery, a solid, fan-like fibrous connective tissue was removed, together with the vertex of the urinary bladder and peritoneum. Adhering loops of the terminal ileum were sharply separated and sutured. Histopathological examination confirmed actinomycosis of the urachus persistens penetrating into the ileum.

Infantile granulomatous urachal abscess with acute localized peritonitis and appendicitis.

Infected urachal remnants in early childhood are occasionally seen. However, intraperitoneal penetration of an infected urachal remnant, resulting in acute peritonitis, is rare. We report a case of infantile granulomatous urachal abscess extending into the peritoneum and appendix. The diagnosis and treatment of urachal abscess in childhood are discussed.