First one with correct answer with justification win.

 

[size=20px]A newborn boy has urine draining from the umbilicus. After physical exam there is a clinical diagnosis of a patent urachus that is confirmed by ultrasound. Which of the following untreated associated anomalies is a contraindication to early surgical closure of a patent urachus?

 

A anorectal malformation with rectourethral fistula

 

B horseshoe kidney

 

C myelomeningocele

 

D posterior urethral valves

 

E vesicoureteral reflux[/size]

D

D

correct

 

A patent urachus that is draining urine out the umbilicus is usually excised completely and closed at the level of the bladder. A contraindication to that plan would be a distal urinary tract obstruction such as posterior urethral valves since closing the “pop-off valve” would potentially lead to a urinary tract obstruction.