A newborn has clear urine leaking continuously from the umbilicus. Ultrasound shows a patent channel connecting the urinary bladder to the umbilical surface. Which structure failed to obliterate?

• A Urachus ✓
• B Processus vaginalis
• C Vitello-intestinal duct
• D Obliterated umbilical artery

Explanation

The urachus is the proximal intra-abdominal part of the allantois, connecting the apex of the bladder to the umbilicus, and normally fibroses into the median umbilical ligament. Complete persistence produces a patent urachus with urine leaking from the umbilicus. C vitello-intestinal remnant discharges meconium-like or mucoid intestinal content, not urine, and is associated with Meckel diverticulum. Partial urachal persistence instead gives a vesicourachal sinus, urachal cyst or umbilical sinus depending on which end remains open.

Reference: Gray's Anatomy for Students, 4th ed.

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Written and medically reviewed by the StethoPrep medical team.