Urachal cysts and urachal fistulas

　　The etiology of urachal cysts and urachal fistulas is that during the embryonic period, when the bladder is expanded to the umbilicus at 10-24 millimeters in size, the bladder then descends along the anterior abdominal wall. During this descent process, a thin tube remains connected to the urachus, which gradually becomes thinner and closes to form a fibrous cord connecting the umbilicus to the anterior bladder wall. If it is not completely closed and there is still a cavity, it becomes an urachal fistula; if both ends are closed but the middle part is not completely closed, there is a possibility of forming a cyst.

　　Umbilical infection is the most common complication of the disease. Urachal cysts are manifested as a cystic mass in the midline of the lower abdomen, not changing with body position, superficially close to the abdominal wall, with delayed healing of the wound and leakage, sometimes with redness and swelling of the umbilical ring, small granulation tissue surface visible in the umbilical concavity, or a small amount of mucus or purulent secretion at the umbilical stump. In severe cases, symptoms of cellulitis such as redness, swelling, heat, and pain may occur. When the infection is more severe, there will be obvious redness, swelling, and hardening around the umbilicus, with a large amount of purulent secretion. Light pressure on the umbilical area may cause pus to flow out of the umbilical concavity with an odor.

　　What are the symptoms of urachal cysts and urachal fistulas? A simple introduction is as follows:

　　1. Urachal fistula:Manifested as a moist navel with thin secretions.

　　2. Urachal cyst:Manifested as a cystic mass in the midline of the lower abdomen, not changing with body position.

　　3. Abnormal urachus:If the urachus does not regress and close during the embryonic period, the bladder will be connected to the umbilicus after birth, which is called an urachal fistula. If both ends are closed but there is a cavity in the middle segment, it will form an urachal cyst. If one end is closed, it will form an umbilical sinus or a bladder dome diverticulum. Urachal fistulas are more common in males, manifested as urinary leakage from the umbilicus, which can be diagnosed by imaging and the fistula can be surgically closed.

　　How to prevent urachal cysts and urachal fistulas? A simple introduction is as follows:

　　1. The main causes of umbilical infection in children, if the child's navel leaks fluid, it should be considered as a disease and seek medical treatment. Delaying the condition can lead to the spread of infection and endanger the child's life.

　　2. If there is no infection, antibiotics may not be needed before surgery, and only general antibiotics are needed after surgery to prevent infection. However, if there is a urinary tract infection and umbilical urachal abscess, antibiotics should be used, and intravenous medication is preferred. Generally, 1-2 antibiotics are sufficient, and mainly rely on surgical treatment.

　　What examinations should be done for umbilical urachal cysts and fistulas? Indigo can be injected into the bladder to clarify it. If there is a small amount of secretion that is sticky fluid, the possibility of an umbilical enteric fistula is much greater than this disease, and further identification is needed.

　　1. A deep mass can be felt in the median line of the anterior abdominal wall.

　　2. If the cyst ruptures to form a sinus tract, injecting contrast agent through the sinus tract and taking a film can show the cyst cavity.

　　3. Urine flows out through the umbilicus, and injecting contrast agent through the umbilicus or excretory urography can show the fistula.

　　4. Umbilical urachal cysts are mainly detected by ultrasound examination to find a cystic mass in the median abdominal wall.

　　5. If there is a phenomenon of 'urine leakage from the navel', then a fistula angiography should be performed, which often helps to confirm the diagnosis or provide meaningful clues.

　　A brief introduction to the dietary care for patients with umbilical urachal cysts and fistulas:

　　1. It is advisable to keep the diet light, eat more vegetables and fruits, rationally match the diet, and pay attention to sufficient nutrition.

　　2. It is advisable to eat more螺, kelp, seaweed, hawksbill, turtle, sea cucumber, water snake, Job's tears, water chestnut, walnut, goat kidney, pork kidney, hyacinth bean, sand worm, perch, mackerel.

　　3. It is advisable to eat kelp, wakame, seaweed, green crab.

　　4. It is advisable to eat yellowfish bladder, shark fin, water snake, pigeon, jellyfish, lotus root powder, buckwheat, malan head, earth ear, turnip, olive, eggplant, fig, mung bean sprouts, soy milk, amaranth, seaweed, eel.

　　5. It is advisable to eat celery, chrysanthemum, leek, winter melon, black plum, dried persimmon, sesame, lotus seeds, sea cucumber.

　　What are the treatment methods for umbilical urachal cysts and fistulas? A simple introduction is as follows:

　　If there is no infection, surgical removal treatment should be performed; if there is already an infection, actively treat the infection, and after infection control, perform surgical removal treatment.

　　1. Control infection using antibiotics and dressing techniques.

　　2. Surgical removal of cysts.