Persistent Umbilical Discharge in a 10 Years Old Girl: A Case of Patent Ductus Urachus

Abstract

Patent ductus urachus is a rare congenital anomaly resulting from the failed obliteration of the urachal lumen, which normally closes during the second trimester of pregnancy. This persistent communication between the urinary bladder and the umbilicus can lead to continuous or intermittent leakage of urine from the umbilicus. Diagnosing this condition in older children is often challenging due to its nonspecific clinical presentation, which may mimic common conditions such as omphalitis or umbilical granuloma. Delayed diagnosis increases the risk of recurrent infections, urachal cyst formation, and, in adulthood, malignant transformation into urachal adenocarcinoma. We report the case of a 10-year-old girl with a lifelong history of persistent, clear, and urinous-smelling discharge from the umbilicus since birth. Physical examination revealed a moist umbilical area without significant signs of acute infection. Ultrasonography confirmed the presence of a tubular structure connecting the bladder dome to the umbilicus. The patient successfully underwent surgical excision of the urachal remnant with no postoperative complications. In conclusion, clinical vigilance regarding persistent umbilical complaints is crucial for primary care physicians. Early surgical intervention is definitive, curative, and serves as a vital preventive measure against the risk of future malignancy.