PERSISTENT PATENT URACHUS WITH ALLANTOIC CYST - A CASE-REPORT

Patent urachus results when there is a persistence of an allantois rem nant which normally undergoes atresia during embryological development . It can lead to an abdominal wall defect similar in appearance on ult rasound to an omphalocele. A 34-year-old primigravida presented at 19 weeks' gestation for evaluation of a cystic mass arising at the umbili cal cord insertion. The initial impression of the referring physician was an omphalocele. The mass arose from the abdominal wall and the umb ilical cord inserted into the membranous covering of the mass, which a ppeared to be fluid-filled and separate from but contiguous with the u rinary bladder. Serial sonography followed the progression of the abdo minal wall mass. At term, the patient underwent primary Cesarean secti on with delivery of a 4494-g male infant. The infant underwent repair and closure of the patent urachus and plastic reconstruction of the ab dominal wall. When the urachus remains patent, it can lead to a urinar y fistula which mimics the ultrasound appearance of an omphalocele. Ho wever, patent urachus is associated with a much lower rate of abnormal ities than omphalocele, yielding a better fetal prognosis.