Srisupundit Kasemsri, Mahawong Phitsanu, Charoenratana Cholaros, Tongsong Theera
Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
J Med Ultrason (2001). 2018 Jul;45(3):529-533. doi: 10.1007/s10396-017-0856-8. Epub 2018 Jan 9.
A 26-year-old pregnant woman was diagnosed with fetal bladder prolapse following rupture of a patent urachus/urachal cyst, based on the finding of cyst disappearance with replacement with an infra-umbilical, extra-abdominal solid soft-tissue mass, mimicking bladder exstrophy. The neonatal findings confirmed the prenatal diagnosis. The baby was healthy and had a successful surgical correction. This report provides clues to differentiating ruptured bladder prolapse from bladder exstrophy as follows: (1) well-documented urachal cyst with urine-filled mass in the early gestation, (2) development of solid soft-tissue mass shortly after disappearance of the urachal cyst, and (3) no other structural abnormalities (bladder exstrophy is usually associated with abnormal genitalia, epispadias, or pubic diastasis). This study underlines the differentiation between the two entities because of the vast difference in prognosis, management, and proper counseling.
一名26岁孕妇在脐尿管未闭/脐尿管囊肿破裂后被诊断为胎儿膀胱脱垂,依据是囊肿消失并被脐下、腹外实性软组织肿块取代,类似膀胱外翻。新生儿检查结果证实了产前诊断。婴儿健康,手术矫正成功。本报告提供了如下鉴别破裂膀胱脱垂与膀胱外翻的线索:(1)孕早期有记录良好的充满尿液的脐尿管囊肿;(2)脐尿管囊肿消失后不久出现实性软组织肿块;(3)无其他结构异常(膀胱外翻通常伴有生殖器异常、尿道上裂或耻骨分离)。由于预后、管理和适当咨询方面存在巨大差异,本研究强调了这两种情况的鉴别。