ISSN 2398-2993      

Patent urachus

obovis

Synonym(s): persistent urachus


Introduction

  • Cause: congenital and acquired forms of failure of the urachus to occlude at the umbilicus. Acquired types may be associated with systemic debilitation and/or umbilical infection.
  • Signs: presents within first 2 weeks of life with moist umbilicus and leakage of urine from the patent urachus. In acquired forms there may be severe systemic signs in a compromised neonatal calf.
  • Diagnosis: history, signs.
  • Treatment: medical vs surgical, local umbilical cleaning/skin protection, possibly cautery, primary problem care and surgical resection of the umbilical remnants with persistent cases.
  • Prognosis: guarded in systemically ill calves.

Pathogenesis

Pathophysiology

Congenital urachus syndrome

  • Urachus never closes at birth .
  • Unknown etiology possibly due to distention from cord torsion in utero or during delivery leading to tension of the umbilicus, dilation of the urachus and preventing occlusion/ incomplete urachal involution.
  • Often accompanied by other congenital abnormalities.

Acquired urachus syndrome

  • Re-opens post-partum as the dried umbilical stump falls off.
  • Associated with umbilical infection/inflammation.
  • Any cause of increased intra-abdominal pressure, eg meconium retention (tenesmus, dysuria etc).
  • Excessive wetness or trauma to the umbilical stump, eg iatrogenic, over-zealous dam, etc.
  • Prolonged recumbency in debilitated calves.
  • Urine leakage   →   persistent irritation and potential source of infection.
  • Urachal wall thinner than bladder wall and hence more prone to rupture.
  • Spread of infection to intra abdominal umbilical remnants common in calves. Ascending infection can affect the bladder and if infection tracks up the umbilical blood vessels, the liver.

Timecourse

  • Acquired forms develop in the first 2 weeks of life.
  • Congenital forms are present at birth.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed Papers

  • Recent references from PubMed and VetMedResource.
  • Nikahval B & Ahrari Khafi M S (2013) Congenital persistent urachus, urethral obstruction and uroperitoneum in a calf. Iranian J Vet Res 14 (2), 158-160.
  • Braun U & Nuss K (2015) Uroperitoneum in cattle: Ultrasonographic findings, diagnosis and treatment. Acta Vet Scand 57 (1), 36 PubMed.

Other sources of information

  • Bishop Y (2005) Ed The Veterinary Formulary. 6th edn. Pharmaceutical Press. ISBN: 0-85369-579-2.

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