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病例报告:伴有脐尿管未闭和单脐动脉的尿囊囊肿的产前和产后管理

Case Report: Pre- and postnatal management of an allantoic cyst with patent urachus and single umbilical artery.

作者信息

Trong Thach Than, Duy Quan Vo, Diem Nghi Tran, Hoang Anh Nguyen, Phi Hung Le, Thien Luan Nguyen, Phuoc Long Nguyen

机构信息

University of Medicine and Pharmacy, Ho Chi Minh City, Ho Chi Minh, 70000, Vietnam ; Hung Vuong Hospital, Ho Chi Minh City, Ho Chi Minh, 70000, Vietnam.

University of Medicine and Pharmacy, Ho Chi Minh City, Ho Chi Minh, 70000, Vietnam.

出版信息

F1000Res. 2015 May 22;4:124. doi: 10.12688/f1000research.6546.1. eCollection 2015.

Abstract

Patent urachus is a rare congenital abnormality. Since its first description by Cabriolus in 1550, few cases have been reported. A 26-year-old Vietnamese primigravida presented at 20 weeks of gestation for evaluation of a cystic mass in the umbilical cord, which was first discovered at week 13 of pregnancy by ultrasound scan. The cystic mass originated from the root of the umbilical cord, connected to the urinary bladder, and no intestinal contents were enclosed within. Doppler ultrasound assessment showed that the single umbilical artery existed within the normal range. The progression of the umbilical cyst continued to be screened, but the mass disappeared on ultrasound images at 27 weeks of gestation. This led to the consideration of the cyst's rupture. After 38 gestational weeks, the pregnant woman delivered a 3350g male infant via cesarean section because of an obstructed vaginal labor. The following days, a stream of urine was recorded leaking out from the umbilical mass whenever he cried. Seven weeks after delivery, an open surgical approach was successfully performed. The baby is now 43 months of age, growing and developing normally. Since an allantoic cyst with patent urachus is a rare clinical entity, early discovery, close monitoring and accurate diagnosis through ultrasound in the prenatal period may consequently allow clinicians to have suitable attitudes towards management when the infant is born.

摘要

脐尿管未闭是一种罕见的先天性异常。自1550年卡布廖洛斯首次描述以来,报道的病例很少。一名26岁的越南初产妇在妊娠20周时因评估脐带内的囊性肿物就诊,该肿物在妊娠13周时经超声检查首次发现。囊性肿物起源于脐带根部,与膀胱相连,内无肠内容物。多普勒超声评估显示单脐动脉在正常范围内。持续对脐部囊肿进行超声检查,但其在妊娠27周时在超声图像上消失,考虑囊肿破裂。妊娠38周后,因阴道分娩受阻,该孕妇行剖宫产分娩一3350g男婴。此后数天,记录到婴儿哭闹时脐部肿物有尿液流出。出生7周后,成功实施了开放性手术。婴儿现43个月龄,生长发育正常。由于伴有脐尿管未闭的尿囊囊肿是一种罕见的临床情况,因此产前通过超声早期发现、密切监测及准确诊断,可使临床医生在婴儿出生时对其处理有恰当的态度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0c7/4505787/ba0456424d6c/f1000research-4-7029-g0000.jpg

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