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Patent urachus with bladder prolapse

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

G3P2 at 23 weeks, referred to our clinic for morphological study of the 2nd trimester.

Patient Data

Age: 30 years
Gender: Female
ultrasound

There is a midline abdominal cystic structure at the umbilical region (allantoic cyst), communicating with the anterosuperior aspect of the fetal bladder via the patent urachus. The umbilical vessels are seen on the periphery of this cystic structure.  

No renal anomalies were seen. Normal amount of amniotic fluid

Case Discussion

Patent urachus with an allantoic cyst is extremely rare. The urachus is a remnant fibrous tissue of the fetal allantois which should involute into the median umbilical ligament. The failure of this involution results in an open cystic tract communicating the umbilicus to the fetal bladder.

The differential diagnosis should include omphalocele and bladder exstrophy.

The treatment is surgical.

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