- 期刊
Urachal Anomalies: Acquired Patent Urachus and Giant Urachal Cyst-2 Cases Report
臍尿管異常－後天性臍尿管開放與巨大臍尿管囊腫
摘要
臍尿管異管是一種相當少見的疾病，Blichert-Toft統計了1550至1971年間，全世界僅報告了315例，且大部分是先天性。茲提出兩罕見成年人臍尿管異常，分別是後天性臍尿管開放與巨大臍尿管囊腫，後皷合併結石及其巨大容積是首次報告。 兩例均是以超音波在術前作出正確診斷。其臨床徵象，超音波檢查，放射線攝影及核磁共掃描均將提出。 臍尿管囊腫通常沒有症狀，假如發生感染，可能會往肚臍及膀胱間形成瘻管，造成所謂後天慌臍連管開放。 治療方面，一例將臍尿管及膀胱頂部切除，另一例將臍尿管及膀胱頂切除，另一例將囊腫壁燒灼及結石取出。假如臍尿管上皮細胞尚未完全破壞，單純結紮，電燒，或引流往往會造成再發，且曾有報告指出會形成腺癌。而臍尿管開放的治療還需包括尿道阻塞原因的矯正。 年輕成人如有肚臍分泌液、下腹痛，或下腹中線腫塊、臍尿管異常均需列入鑑別診斷之中。
關鍵字
無資料並列摘要
Two cases of rare urachal anomalies in the adult are described, including one acquired patent urachus and one giant urachal cyst. The presenting symptoms and signs included pyuria, fever, lower abdominal pain and palpable abdominal mass. The correct preoperative diagnosis was made after sonography. The clinical and radiographic features and magnetic resonance imaging are presented. Stone formation and the huge capacity of the urachal cyst are first reported. Excision of the urachal tract with resection of the bladder dome and cauterization of the cystic wall with stone removal were performed in that order. When a young adult presenting with a wet umbilicus, acute abdominal pain or a lower midline abdominal mass, the possibility of an infected urachal anomaly should be considered in the differential diagnosis.