VETERINARY CLINICAL SCIENCE

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CASE REPORT
Successful Management of Pervious Urachus by Orthogonal Subcutaneous
Ligatures
Ram Niwas1, Sandeep Kumar2, Dinesh1* and Sandeep Saharan3
1
Assistant Professor, 2Scientist, Department of Veterinary Surgery and Radiology, 3Assistant Professor, Department
of Veterinary Clinical Complex, Lala Lajpat Rai University of Veterinary and Animal Sciences, Hisar, Haryana,
India.

Abstract
* Pervious urachus is a congenital abnormality characterised by
Corresponding Author:
dribbling of urine and wetting of area around umbilicus. Three new born
Dinesh calves were presented with history of dribbling of urine form umbilical area
E mail: dd2012vets@gmail.com since birth. Authors surgically managed three cases by subcutaneous
ligatures centring urachal opening. To the best of author’s knowledge till
Received: 08/09/2020 presentation of this article, there are no published peer-reviewed case
Accepted: 29/09/2020 reports of this procedure in calves.

Keywords: Ligature, Orthogonal, Pervious urachus, Subcutaneous,

Umbilical.
1. Introduction Complex. All calves have normal feeding and
Pervious urachus is one of the most common defecation except voiding the urine from abnormal site.
congenital abnormalities of urinary system. This Clinical examination revealed normal respiration rate,
condition is more commonly observed in the foals (Mc heart rate and rectal temperature in all calves. All the
Gavin et al., 2001), cow calves (Dilipkumar and Dhage, cases were diagnosed as the previous urachus. There
2010) and rare in the buffalo calves (Singh et al., was normal skin texture around the opening (Fig 1b)
2020). The contents of umbilicus in newborn calves are and there was no sign of oedema, inflammation in two
urachus, a tube that connects the fetal bladder to the calves while in one slight inflammation was present
placental sac and the remnants of the umbilical vessels that might be due to forceful pulling or close severing
that transports blood between the foetus and its mother. of umbilical cord after birth (Fig 1a). Grossly there was
During foetal life, excretion of waste material occurs no evidence of infection in all cases.
through urachus that communicates with allantois, after
parturition becomes atrophied and its lumen gets 3. Surgical Treatment
obliterated (Laverty and Salisbury, 2002). Normally, All the calves were prepared for aseptic surgery
these structures shrink until only tiny remnants remain after shaving around the umbilical area and put in right
within the abdomen. Ascending infection to urinary lateral recumbency. Five ml of 2% lignocaine
bladder may occur if the urachus remains open for hydrochloride was infiltrated linearly on umbilical
longer period (Langan et al., 2001). Both surgical and stump and a two inch long skin incision starting from
conservative treatments are indicated (Singh et al., terminal part of umbilicus, was given longitudinally
2020). In Conservative treatment cotton swab dipped in avoiding cutaeneous blood vessels in all calves.
90% phenol is applied inside the urachus towards the Subcutaneous fascia was dissected bluntly with scissor.
urinary bladder. Singh et al. (2020) also described After that two ligatures keeping the urachal opening in
surgical treatment when conservative treatment fails or centre applied orthogonally with non absorbable suture
infection present. In order to obliterate urachus, two material to obliterate the opening completely at a
ligatures are applied after entering in to abdominal distance of one centimetre (Fig 1c). Lastly skin incision
cavity by giving incision over umbilicus in cranio was closed using two or three simple interrupted
caudal direction using absorbable suture material. The sutures. Just after the end of surgical procedure there
present paper put on record to describe new method of was no dribbling of urine from umbilical area. Post
successful surgical management of this congenital operatively only analgesic, meloxicam @ 0.5mg/kg
abnormality by applying two orthogonal subcutaneous (Papich, 2011) for three days along with antiseptic
ligatures on umbilical stump without entering dressing and fly repellent topical spray till healing,
abdominal cavity. were prescribed. Course of antibiotics was skipped, as
there was no surgical entrance of abdominal cavity. The
2. Case History and Observations outcome of the surgery was successful in all animals
Three buffalo calves of age between 1 to 3 days and there was no reoccurrence or other complication
were presented with history of dribbling of urine from recorded for one month period of follow up.
umbilical area since birth to Veterinary Clinical

Veterinary Clinical Science | July-September, 2020 | Volume 08 | Issue 03 | Pages 75-76

© 2020 Jakraya
 Niwas et al...Successful Management of Pervious Urachus by Orthogonal Subcutaneous Ligatures

a b c
Fig 1: (a) Very close serving of umbilicus (b) Pervious urachus with umbilical stump (c) Subcutaneous ligature.

4. Result and Discussion major surgery in neonatal life. The reduced abdominal
Patent urachus is a condition in which the exposure of this minimally invasive technique makes it
urachal duct fails to degenerate after parturition. During a suitable especially under field conditions. The time
prenatal life, the urachus forms the communication taken from incision of the skin to last suture was
between the bladder and the allantoic cavity for urine considered as the time required for surgery. The mean
excretion. Failure of the duct to close at birth leads to time taken for this technique was 7.6 minutes (range
this anomaly which is commonly found in calves (Rao five to 10 minutes). Large laparotomy incision exposes
et al., 2000). This reported technique is very simple and a larger area of the peritoneal cavity to the outside
applicable to all non infected cases of pervious urachus. environment for a longer time that further increases the
Further it does not compromise vascular supply distal chances of infection (Fazili et al., 2010).
to ligatures because subcutaneous blood vessels nourish
the stump distal to applied ligatures. Main objective of 5. Conclusion
conventional surgical and conservative technique is to The technique used in the present study is non
obliterate the abnormal urinary passage. But in invasive and requires minimal suturing. Unlike the
conventional surgical technique there is necessity of conventional surgical procedure, this does not involve
opening the abdominal cavity and in later there may be long laparotomy incision. The reduced abdominal
reoccurrence and surgical treatment is indicated (Singh exposure makes it a suitable alternative procedure,
et al., 2020; Khan et al., 2020). Using this technique especially under field conditions.
author over came from drawbacks of both conventional
surgical and conservative technique as well as stress of

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Veterinary Clinical Science | July-September, 2020 | Volume 08 | Issue 03 | Pages 75-76

© 2020 Jakraya
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