PMC6215960_01
a) A longitudinal ulcer is noted in a small bowel series. b) urachal mass extends into the umbilicus on computed tomography.
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A small bowel series identified a longitudinal ulcer and subsequent abdominal computed tomography (CT) showed an ileal stricture and an urachal tumor mass that extended into the umbilicus (Fig. 1a, b).
a) A remnant urachus and the urinary bladder are seen. An intestinal lesion adheres to the urachus around the urinary bladder, and the remnant urachus appears swollen. b) The inflammatory mass includes the urachus and intestinal lesion.
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Intraoperatively, it was found that the urachal remnant connected to the urinary bladder (Fig. 2a, b), and the Crohn's disease-related intestinal lesion had formed a fistula to the urachus.
Operative procedure and resected specimen.. a) Operative findings.. b) Ileum with Crohn's disease.. c) Abscess formation in the urachus. The extent of resection of the shema is part of the circle. Partial ileal resection, urachal resection, and partial cystectomy were performed. Reconstruction involved ileal end to end anastomosis.
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The patieint underwent a partial ileal resection, urachal resection, and partial cystectomy (Fig. 3a-c).
a) Non-caseating epithelioid granulomas in the muscularis propria of the small intestine and inflammation of all organ layers are seen. These findings are which is a characteristic of Crohn's disease. b) Extensive neutrophil inflammation and a strong inflammatory response to foreign substances beneath the epithelium of the urachus are seen.
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There was extensive neutrophil infiltration and inflammation beneath the epithelium of the urachus because of exposure to foreign substances (Fig. 4a, b).
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a) Inflammation of the umbilicus. b) Operative findings show a periumbilical inflammatory lesion extending to the bladder through the urachal remnant and to the ileal lesion.
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Intraoperatively, it was found that the patient had a periumbilical inflammatory lesion extending to the bladder through the urachal remnant and the longitudinal ulcer of the ileal lesion (Fig. 5a, b).