Tolaymat L L, Maher J E, Kleinman G E, Stalnaker R, Kea K, Walker A
Department of Obstetrics and Gynecology, University of Florida, Pensacola 32503, USA.
Ultrasound Obstet Gynecol. 1997 Nov;10(5):366-8. doi: 10.1046/j.1469-0705.1997.10050366.x.
Patent urachus results when there is a persistence of an allantois remnant which normally undergoes atresia during embryological development. It can lead to an abdominal wall defect similar in appearance on ultrasound to an omphalocele. A 34-year-old primigravida presented at 19 weeks' gestation for evaluation of a cystic mass arising at the umbilical cord insertion. The initial impression of the referring physician was an omphalocele. The mass arose from the abdominal wall and the umbilical cord inserted into the membranous covering of the mass, which appeared to be fluid-filled and separate from but contiguous with the urinary bladder. Serial sonography followed the progression of the abdominal wall mass. At term, the patient underwent primary Cesarean section with delivery of a 4494-g male infant. The infant underwent repair and closure of the patent urachus and plastic reconstruction of the abdominal wall. When the urachus remains patent, it can lead to a urinary fistula which mimics the ultrasound appearance of an omphalocele. However, patent urachus is associated with a much lower rate of abnormalities than omphalocele, yielding a better fetal prognosis.
脐尿管未闭是由于尿囊残余持续存在所致，尿囊在胚胎发育过程中通常会闭锁。它可导致腹壁缺损，超声表现与脐膨出相似。一名34岁初产妇在妊娠19周时因评估脐带插入处出现的囊性肿物前来就诊。转诊医生最初的诊断是脐膨出。肿物起源于腹壁，脐带插入肿物的膜性覆盖物，肿物似乎充满液体，与膀胱分离但相邻。超声检查跟踪腹壁肿物的进展情况。足月时，患者接受了首次剖宫产，娩出一名体重4494克的男婴。该婴儿接受了脐尿管未闭的修复和腹壁整形重建。当脐尿管保持开放时，可导致尿瘘，其超声表现类似脐膨出。然而，脐尿管未闭相关的异常发生率远低于脐膨出，胎儿预后更好。
