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Journal of the Korean Society of Pediatric Nephrology 2005;9(2): 213-221.
요막관 기형의 임상적 고찰
이상배, 정창현, 김강성, 류민혁, 이동진
1울산동강병원 소아과
2울산동강병원 소아과
3울산동강병원 소아외과
4울산동강병원 소아과
5울산동강병원 소아과
A Clinical Observation of Children with Urachal Anomalies
Sang-Bae Lee, Chang-Hyun Jung, Kang-Sung Kim, Min-Hyuk Ryu, Dong-Jin Lee
1Department of Pediatrics, Dong Kang General Hospital
2Department of Pediatrics, Dong Kang General Hospital
3Department of Pediatric Surgery, Dong Kang General Hospital
4Department of Pediatrics, Dong Kang General Hospital
5Department of Pediatrics, Dong Kang General Hospital
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ABSTRACT
Purpose : Urachal anomalies are rare but are known to develop several complications, especially infection. Moreover, uniform guidelines for management have not been presented because of the variable clinical characteristics of these anomalies. The purpose of this report is to review our experience with urachal anomalies and attempt to determine the optimal management.
Methods : We retrospectively reviewed the records of fourteen children with a variety of urachal anomalies who had been treated from January 1996 to June 2005 at Dong Kang General Hospital.
Results : The age distribution of the patients(mean age; 3.8 years) was six neonates, one infant, five preschool-age and two school-age children. The male to female ratio was 1:1. Six cases of urachal cyst, four cases of patent urachus, two cases of urachal sinus and two cases of urachal diverticulum were found. Three patients with patent urachus and one with urachal cyst had hydronephrosis. Other associated anomalies included an inguinal hernia in one patient with urachal sinus and a vesicoureteral reflux in one patient with urachal diver ticulum. As a first-line diagnostic tool, high-resolution ultrasound examination was performed in thirteen cases and computed tomography in one case. Surgical excision was performed in nine patients with urachal anomaly. Five cases out of six neonatal cases experienced spontaneous improvement during a three-month follow up period. Due to frequent infection of the umbilicus, surgical excision was performed on one neonate with urachal sinus.
Conclusion : All patients with urachal anomalies should undergo investigation for associated anomalies. The neonate with urachal anomalies, especially patent urachus, do not require surgical excision unless the patient has multiple episodes of recurrent infection. (J Korean Soc Pediatr Nephrol 2005;9:213-221)
Key words: Urachal anomaly | Patent urachus | Urachal cyst | Urachal sinus | Urachal diverticulum
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