Post Show Quiz Vesicourachal Diverticulum
The urachus is the embryological derivative of the:
allantois
bladder
cloaca
yolk sac
The allantois becomes the urachus, which connects the yolk sac to the fetal bladder.
Vesicourachal diverticulum increases risk of:
gastrointestinal neoplasms
internal hemorrhoids
nephrolithiasis
urinary tract infections
A vesicourachal diverticulum is an outpouching of the bladder. It is important for clinicians to consider this pathology in a patient with a history of recurrent UTIs.
Within the bladder diverticulum, increased risk of bladder calculi is most likely due to:
dehydration
hypercalcemia
urinary stasis
urinary tract infection
Urinary stasis, which is a result of bladder diverticula, increases the risk of peripheral calcifications. This is important to consider in cases of calcification due to mucinous tumors as well.
Urachus involutes normally to become the:
Inferior epigastric vessels
lateral umbilical fold
median umbilical ligament
umbilical artery
In normal development, the urachus eventually regresses to a fibrous band, known as the median umbilical ligament. Abnormal development of the urachus can lead to a patent urachus, urachal sinus, urachal cyst, or vesicourachal diverticulum.
Urachal carcinomas are most commonly located in the:
pouch of douglas
space of borgros
space of retzius
rectum
The typical extension of urachal carcinomas is along the Retzius space, which can help differentiate from vesical carcinomas. The differential diagnosis includes adenocarcinomas of non-urachal origin, infected urachal remnants, metastasis, and transitional cells.
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