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• W4280501492 abstract "We wish to reply to the response letter for our recent article titled “Umbilical cord cyst with patent urachus presenting as urine jet from umbilicus: A case report.1Lin C.C. Huang C.B. Su J.C. Chou Y.K. Chiang K.L. Umbilical cord cyst with patent urachus presenting as a urine jet from the umbilicus: a case report.Pediatr Neonatol. 2021; 63: 105-106Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar” First, after a more careful literature search, we found several prenatal cases of umbilical cord cysts with a patent urachus.2Weichert J. Chiriac A. Kaiser M. Thorns C. Axt-Fliedner R. Prenatal management of an allantoic cyst with patent urachus.Arch Gynecol Obstet. 2009; 280: 321-323Crossref PubMed Scopus (15) Google Scholar, 3Umeda S. Usui N. Kanagawa T. Yamamichi T. Nara K. Ueno T. et al.Prenatal and postnatal clinical course of an urachus identified as an allantoic cyst in the umbilical cord.Eur J Pediatr Surg. 2016; 26: 200-202Crossref PubMed Scopus (4) Google Scholar, 4Bunch P.T. Kline-Fath B.M. Imhoff S.C. Calvo-Garcia M.A. Crombleholme T.M. Donnelly L.F. Allantoic cyst: a prenatal clue to patent urachus.Pediatr Radiol. 2006; 36: 1090-1095Crossref PubMed Scopus (26) Google Scholar In our case, the existence of continuous urinary drainage from the umbilical cord stump was not seen at the beginning; thus, we did not immediately detect the patent urachus. We want to remind readers that pediatricians must carefully examine neonates with a prenatally detected umbilical cord cyst because the cyst may be associated with a patent urachus, which requires a pediatric surgical consult. Second, suspected urachal anomalies can be imaged through various modalities, including ultrasonography, fistulography, computed tomography, and magnetic resonance imaging. Ultrasonography is more suitable as a preliminary diagnostic tool because of its feasibility and because it does not involve radiation exposure. However, the examination should be selected on a case-by-case basis.5Wilson A.L. Gandhi J. Seyam O. Rahmani B. Patel S. Joshi G. et al.Urachal anomalies: a review of pathological conditions, diagnosis, and management.Translational Research in Anatomy. 2019; 16: 100041Crossref Scopus (4) Google Scholar,6Parada Villavicencio C. Adam S.Z. Nikolaidis P. Yaghmai V. Miller F.H. Imaging of the urachus: anomalies, complications, and mimics.Radiographics. 2016; 36: 2049-2063Crossref PubMed Scopus (49) Google Scholar In our case, due to delayed healing of the umbilical cord stump and suspicion of omphalitis, systemic infection, or even other abnormalities and complications, we arranged for abdominal computed tomography. The approach to managing most urachal abnormalities, especially the patent urachus, has historically been surgical excision. Although accumulating evidence suggests that obliteration may occur postnatally in some minimally symptomatic cases, which has caused a paradigm shift,7Dethlefs C.R. Abdessalam S.F. Raynor S.C. Perry D.A. Allbery S.M. Lyden E.R. et al.Conservative management of urachal anomalies.J Pediatr Surg. 2019; 54: 1054-1058Abstract Full Text Full Text PDF PubMed Scopus (9) Google Scholar we considered surgical excision due to persistent umbilical drainage and delayed cord stump healing. Although surgical excision was performed, the wound was only 2-cm long. During the operation, methyl blue was injected from the urethral catheter to the bladder to determine the status of the patent urachus, and urinary system abnormalities such as vesicoureteral reflux and obstructive ureteropathy were excluded. The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article." @default.
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• W4280501492 date "2022-07-01" @default.
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• W4280501492 title "Response to Commentary on“Umbilical cord cyst with patent urachus presenting as urine jet from umbilicus: a case report”" @default.
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• W4280501492 doi "https://doi.org/10.1016/j.pedneo.2022.04.003" @default.
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