A new born presents with discharge of urine from the umbilicus for 3 days. Diagnosis is -
• A patent urachus seldom reveals itself until maturity or even old age.
• This is because the contractions of the bladder commence at the apex of the organ and pass towards the base.
• Because it opens into the apex of the bladder a patent urachus is closed temporarily during micturition and so the potential urinary stream from the bladder is cut off.
• Thus, the fistula remains unobtrusive until a time when the organ is overfull, usually due to some form of obstruction.
Treatment
• Remove the obstruction in the lower urinary tract.
• If the leak continues or a cyst develops in connection with the urachus: Umbilectomy and excision of the urachus
Meckel's diverticulum
Mesenteric cysts
Urachal fistula
Omphalocele