Season 3 Case 29
History: Other (everyone’s favorite)
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Case 29 Answer
Check out the dome of the bladder and how it is pulled anterior and upward, with a thin strand of tissue (which had a small amount of fluid) extended up towards the umbilicus.
Answer: Vesicourachal diverticulum
Part of a spectrum of urachal remnants, the urachus should become obliterated post birth and turn into the median umbilical ligament. Persistence of parts or all or the urachus lead to everything from a patent urachus (technically would act as a fistula between the bladder and the umbilicus) to a urachal cyst (a cyst not connected to the umbilicus or bladder) or a umbilical or vesicular diverticulum). This was in an asymptomatic person and the cranial part was essentially non-existent so I called it a vesicourachal diverticulum.