Sag CT of the abd shows a track extending from the bladder d | Figure 1

CincyKidsRad

Cincinnati Children's Radiology

Sag CT of the abd shows a track extending from the bladder dome to umbillicus. Urachal remnant anomalies are a spectrum of congenital anomalies including patent urachus (open connection between bladder and skin), urachal sinus (blind ending sinus tract from skin), urachal diverticulum (blind ending tract from bladder), and urachal cyst (cyst, no open connection to skin or bladder). #TummyTuesday

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Coronal (image 1) and axial (image 2) images from fetal MRI show an abnormal appearance of the kidneys (arrows) with multiple cortical cysts and massive enlargement of the ureters (arrowheads). On postnatal voiding cystourethrogram (image 3) bladder rupture is visible. Contrast fills the urinary bladder (arrowhead). There is leakage of contrast (arrow) from the right lateral aspect of the bladder and pooling (dashed arrow) within the right lower quadrant. Posterior urethral valves is the most common cause of fetal bladder outlet obstruction. Bladder rupture is an uncommon manifestation of this obstruction. High-grade vesicoureteral reflux is more common and leads to kidney damage. Posterior urethral valves as the most common cause of chronic kidney injury in children.](https://app.figure1.com/case-detail/02752614-dd55-4a89-9565-e214db726d3a)



Ultrasound of the bladder shows two hypoechoic ovals posterior to the bladder wall. In this cases, each oval represents a distinct uterine horn consistent with uterine didelphys. Uterine didelphys is a Mullerian anomaly with complete duplication of the uterus and cervix. The vagina is variably duplicated. #TummyTuesday](https://app.figure1.com/case-detail/148da831-1d28-42c0-ad84-3a56293d02d2)



Longitudinal ultrasound extending from the bladder dome (arrowhead) shows a patent urachus (arrow). Patients with a patent urachus typically present with urine leakage from the umbilicus. Other urachal anomalies include urachal diverticulum, urachal sinus, and urachal cyst.](https://app.figure1.com/case-detail/4585f027-c823-45c3-9c32-3296593cda16)



Sagittal T1-weighted images of the lumbar spine reveal a dorsal dermal sinus (arrow) connecting to the skin surface (arrowhead) and a tethered spinal cord (dashed arrow). A dorsal dermal sinus is a type of congenital dysraphism where an epithelial-lined tract extends from the skin to varying depths, potentially to the thecal sac. As this can be a nidus for infection due to the connection to the skin, it can also be associated with other anomalies like tethered cord and split spinal cord malformations.](https://app.figure1.com/case-detail/4a4b5349-9c36-47f6-9bf0-8744098e2f78)