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Images in Paediatrics
A neonate with cystic umbilical cord and wet umbilicus
Un neonato con cordón umbilical quístico y ombligo húmedo
Jazmín Pérez Ramíreza, Julio César Moreno-Alfonsob,c,
Corresponding author
juliomoreno.md@gmail.com

Corresponding author.
, Guillermo Jacobo Serrano Menesesa
a Cirugía Pediátrica, Hospital Pediátrico Moctezuma, Ciudad de México, Mexico
b Cirugía Pediátrica, Hospital Universitario de Navarra, Pamplona, Spain
c Doctoral School, Universidad Pública de Navarra, Pamplona, Spain
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Umbilical cord with a large cyst measuring 7&#8239;&#215;&#8239;4&#46;5&#8239;cm &#40;A&#44; arrowhead&#41; and umbilical granuloma exuding a yellowish fluid after the cord stump fell off &#40;B&#44; arrow&#41;&#46; The fistulogram confirmed the presence of patent urachus &#40;C&#44; arrow&#41; in absence of urethral anomalies &#40;C&#44; arrowhead&#41;&#46; The upper and lateral portions of the latter image feature a radiolucent tubular structure&#44; corresponding to the syringe used to inject the contrast agent&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We present the case of a male infant aged 38 weeks with a cystic umbilical cord &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>A&#41;&#46; At 15 days post birth&#44; after the cord stump fell off&#44; an umbilical granuloma became visible that issued a yellowish fluid&#44; found to be urine after performance of urinalysis &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>B&#41;&#59; a patent urachus was suspected&#44; and an abdominal ultrasound scan ordered in which no abnormalities were identified&#46; The fistula was examined by means of a voiding cystourethrogram&#44; confirming the patent urachus &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>C&#41;&#46; At 23 days post birth&#44; a urachal remnant measuring 1&#46;5&#8239;cm that extended to the bladder dome was excised through an infraumbilical incision&#44; followed by cystorrhaphy and umbilicoplasty &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; The histological examination of the specimen found transitional epithelium&#44; granulation and smooth muscle tissues&#46; The patient had a favourable outcome and was discharged 4 days after the surgery&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Cases of patent urachus associated with umbilical cord cysts are rare&#46; The hypothesis of urinary reflux through the patent urachus with cystic dilation of Wharton&#8217;s jelly was proposed 40 years back&#44; and few cases have been described since&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The differential diagnosis of fluid discharge from the umbilicus and umbilical granuloma must include urachal anomalies&#44; especially if preceded by manifestations such as umbilical cord cyst&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Although spontaneous urachal obliteration in the first 6&#8211;12 months of life has been described in cases with large urachal remnants and a history of cystic umbilical cord&#44; suggestive of significant urinary reflux &#40;as was the case of this patient&#41;&#44; we recommend surgical repair as the preferred approach to lower the risk of infection&#44; acute abdomen and&#44; while rare&#44; malignant transformation in the long term&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0015" class="elsevierStylePara elsevierViewall">This research did not receive any external funding&#46;</p></span></span>"
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          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Infraumbilical incision and dissection of the entire length of the urachus &#40;A&#44; arrowhead&#41; extending to the bladder dome &#40;A&#44; arrow&#41;&#46; Excision of the patent portion of the urachus &#40;B&#44; arrowhead&#41;&#44; three-layer repair of the bladder dome &#40;C&#44; arrow&#41; and cosmetic outcome of the umbilicoplasty &#40;D&#41;&#46;</p>"
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                            0 => "S&#46; Young"
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ISSN: 23412879
Original language: English
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Anales de Pediatría (English Edition)