Urachal cyst
Introduction
Introduction to urachal cyst Urachal cysts (urachalcyst) are rare in the clinic and occur mostly in men. The cyst is located deep in the mid-abdominal wall of the umbilicus, between the transverse fascia and the peritoneum. It is due to the closure of both ends of the umbilicus, while the middle is not closed, and the fluid secreted by the urinary tract epithelium is often found in childhood. basic knowledge The proportion of illness: the incidence rate of infants and young children is about 0.001% Susceptible people: male Mode of infection: non-infectious Complications: cellulitis
Cause
Cause of urachal cyst
Congenital factors:
The urachal cyst is in the development of the fetus, the two ends are closed and a cavity is formed in the middle, which is filled with epithelial secretions or exfoliated cell debris. The urinary tract is completely closed, and symptoms can appear within a few days after birth. It can be seen that there is urine droplets from the umbilicus. The distal part of the urachal catheter forms a spherical nodule, the upper part of which is covered by the skin and partly by the epidermis of the urinary tract, and the surrounding skin is stimulated, but lighter than the feces.
Pathogenesis
There is currently no relevant information.
Prevention
Umbilical cyst prevention
1, urachal cyst, is the main cause of umbilical infection in children, such as the discovery of children's navel water should think of the disease and go to the doctor for treatment, delaying the disease will spread the infection, endangering the lives of children.
2, if the disease is not infected, antibiotics can be used before surgery, only need to use general antibiotics to prevent infection after surgery. However, if combined with urinary tract infection and urachal abscess, antibiotics should be used, and intravenous medication is preferred. It is usually enough to use 1-2 kinds of antibiotics, mainly relying on surgery.
Complication
Urethral cyst complications Complications cellulitis
Umbilical infection in children is the most common complication. The urachal cyst is in the middle of the lower abdomen. The cystic mass does not change with the body position. The superficial surface is closely related to the abdominal wall. The wound is delayed and there is a effusion sometimes. The wheel is red and swollen, and there is a small amount of mucus or purulent secretion in the small granulation surface or umbilical stump in the umbilicus. In severe cases, there may be symptoms of cellulitis such as redness, swelling, heat, and pain. When the infection is more serious, it can be seen that the umbilical cord is obviously red and swollen and hard, and there are more purulent secretions. The umbilical cord is lightly pressed, and the pus flows out from the umbilicus and has an odor.
Symptom
Symptoms of urachal cysts Common symptoms Abscess cysts abdominal pain
The urachal cyst is in the middle of the lower abdomen, cystic mass, does not change with the body position, the position is superficial and the abdominal wall is closely related. The large urachal cyst is similar to the intra-abdominal tumor, which can compress the intestine and cause abdominal pain and other symptoms. Abscesses or cysts can be ruptured due to secondary infection, perforating to the outside of the abdomen, or rupturing into the bladder or into the abdominal cavity and pelvis.
Examine
Examination of urachal cyst
For those suspected of having urachal cysts, B-ultrasound is the first choice, and Prince Dry et al. (1993) describe the following characteristics:
1. The mass of the fusiform anechoic zone is visible in the deep ventral wall of the umbilicus, located between the umbilicus and the bladder.
2. The mass moves in the same direction with deep breathing.
3. In the case of cystic infection, it shows a dense point echo, which is caused by pus in the capsule, tissue debris and necrosis of the parenchyma.
4. The inner wall of the capsule is rough and the outer wall is unclear.
5. When the bladder is filled or empty, the shape of the cyst changes.
6. Intracapsular stones can have strong echoes. In addition, IVU, cystoscopy and abdominal CT scans can help to confirm the diagnosis and help identify other lesions in the abdomen.
Diagnosis
Diagnosis and differentiation of urachal cyst
diagnosis
According to the clinical examination, the superficial cystic mass in the middle of the umbilicus is different in size. The larger one can be touched and more asymptomatic. In the case of secondary infection, local inflammatory reaction occurs. Combined with B-ultrasound, CT, cystography and other imaging examinations can be clear diagnosis.
Differential diagnosis
The possibility of urachal cyst should be considered when there is a deep mass in the midline of the lower abdomen. It needs to be differentiated from swelling of the appendix, Meckel's diverticulum, ovarian cyst, tuberculous peritonitis, etc. B-ultrasound and X-ray lateral radiographs can assist in diagnosis.
