Undiagnosed and Unique Urachal Cyst of Neonate A Brief Case Report in Secondary Health Care
Jovita Olivia,Eriantono Ponco Sudharma
Intern in RSUD Depati Bahrin Pediatrician in RSUD Depati Bahrin
Background : Urachal cyst is a sac-like pocket of tissue that develops in the urachus, a primitive structure that connects the umbilical cord to the bladder in the developing baby. Although it normally disappears prior to birth, part of the urachus may remain in some people. Patent urachus is the commonest type of urachal remnant anomaly with spectrum from urachal sinus, diverticulum, and cyst. It can be present in neonate or adult, varying asymptomatic to presents as urine leaking from the umbilicus during the neonatal period. The diagnosis can be worked up antenatally and postnatally with detail scan of the newborn. Urachal cysts are often not associated with any signs or symptoms unless there are complications such as infection.
Case Presentation Summary : In these cases, symptoms may include fever, difficulty of voiding, hyperbilirubinemia as in or not associated with late onset neonatal sepsis. An Asian five days old male neonates, comes with fifth day of hyperbilirubinemia and difficulty of voiding since his first 24 hours. Present of urachal cyst was confirmed with the ultrasound imaging examination that had demonstrated cystic lesion at paravesica.
Learning Points/Discussion : Another test called a VCUG (voiding cystourethrogram) can also occasionally performed to diagnose urachal cyst. Prognosis of the urachal anomalies are unexpectedly good despite some of anomalies can develop to malignancy. Hence, inspire of nonspecific clinical findings and mimicking other abdominal and pelvic processes, care provider should aware of potential complication to ensure early diagnosis and optimal management. Understanding of the embryonic development of the urachus is necessary for the radiologist to diagnose the wide variety of urachal disease.