Urachal diverticulum

Urachal diverticulum is a rare congenital anomaly that occurs in the urachus, a structure that connects the bladder to the umbilicus (navel) during fetal development. This condition is characterized by a small pouch or sac-like protrusion in the urachus, which typically should close and become a ligament after birth.

Anatomy

The urachus is a midline tubular structure that extends from the bladder apex to the umbilicus. It is a remnant of the allantois, a canal that drains the urinary bladder of the fetus that joins and runs within the umbilical cord. The urachus is usually obliterated during fetal development, transforming into a fibrous cord known as the median umbilical ligament. However, in some cases, this process does not occur completely, leading to urachal anomalies such as urachal diverticulum.

Pathophysiology

In a urachal diverticulum, a portion of the urachus remains open, forming a pouch that is connected to the bladder. This can lead to complications such as recurrent urinary tract infections, bladder stones, and in rare cases, urachal cancer.

Diagnosis

Diagnosis of urachal diverticulum can be challenging due to its rarity and non-specific symptoms. It is often discovered incidentally during imaging studies for other conditions. Ultrasound, computed tomography (CT) scan, and magnetic resonance imaging (MRI) are commonly used imaging modalities.

Treatment

The treatment for urachal diverticulum is usually surgical, involving the complete excision of the urachal remnant to prevent complications. This can be performed using open surgery or minimally invasive techniques such as laparoscopy.

See also

• Urachal cyst
• Urachal cancer
• Urinary bladder