326
2255578220014562122182
Ces36967930014570127174
Urol38957930014578115180208
2024;41287930014562121178235258
28(3):44117930014562121154212241263
221–22747007930014561121176230285345402
ORIGINÁLNÍ3862200016996181224324367468561635735777
PRÁCE4686200016974156253339415
nebo6245240013158110168226
v8695240013149
odstupu9375240013158117155188245303360
po13165240013160117
přeléčení1452524001316091141163214262312368389
zánětlivé1860524001314493150201233255275323374
komplikace.22535240013146101189247270290334384431481497
Popisovány6245390013154108167188226282329377433478
jsou1120539001312461118174
spontánní1313539001314097155212242290346402423
regrese1755539001313181140170220259310
nálezu.20845390013158105126177220277295
U23975390013168
našich24845390013157105143163210266
dvou6245540013160109166224
pacientů8755540013161110159181233291323381
došlo12825540013160118158180238
u15475540013158
jednoho1632554001312376136194252311369
po20285540013160120
konzervativní21745540013147104162206258289342392424446495554576
léčbě624569001312376125185239
ke887569001314798
zhojení10105690013145103161184236294316
a13515690013150
u14255690013159
druhého1509569001315991149207260318376
až1910569001315094
po20295690013161120
derivaci21745690013159112144166216265314336
zhni‑25355690013144103160182215
sané624584001314191149202
cysty.854584001314999140175226239
Vymizel11215840013156105195217261312335
i14845840013122
ultrasonografický1534584001315880114145195235293352410470502552577604652698749
nález23115840013159107130182227
(6,256558400131308098
7,2690584001315460
8,624599001315371
9,715599001315367
10).802599001315399126141
Laparoskopické962599001314999158207238294333378434493516563608659
ošetření1641599001315897149182213263320342
jsme2002599001312462150202
neprováděli.22245990013159111170201257305354413465487508526
Tento624614001315299158190248
přístup905614001316194117157192251312
vidíme1250614001315074134157247301
jako1584614001312474120178
sporný17956140013142102162195255302
s21306140013142
ohledem22056140013159119142196257311402
na26406140013160110
možnou6246290013190147189247305362
diseminaci1006629001316081120172260282339387435456
infekce1482629001312380107159204251301
do18036290013159117
dutiny19406290013159115149170227273
břišní.2233629001316091113152209230248
Určitý2501629001316898144166199249
profit624644001316091146172198230
by8736440013160106
laparoskopie999644001312370129177208263302346402461483534
mohla15526440013189146204225273
znamenat18446440013144101149236288345392424
pro2287644001316091146
věkově2453644001314999144199246297
školní624659001314085140162219240
a8836590013149
starší951659001314174123153193213
děti.11846590013159110142163181
Jinak1384659001313859115163207
u16106590013158
malých16876590013189137158205251308
dětí20146590013159111143164
předškolního2197659001316091141200238282338360416437496553
věku6246740013150103149208
je865674001312377
vhodnější9756740013150110169230289342364404426
klasický1434674001314771121161183232278330
umbilikální17976740013159149210233255277323375398456478
přístup2308674001316194116156191250310
(6,265167400131298099
11,624689001315496108
12)7656890013155100127
(Obr.9256890013130102164197211
10).11696890013155103131146
Některé13486890013172125171209261293346
práce1727689001316294145195247
doporučují20076890013161120182242275334384442465487
spíše25276890013142102126169223
konzervativní6247040013148107168215268302357409443466518580603
postup12627040013162124166202263325
se1622704001314298
sledováním.1755704001314265120183244294347407430522543
Vycházejí23337040013157109159219270317370394417
z6247190013144
uváděných6887190013158107156215267325370417474
spontánních11827190013141100158216248297354411433480537
regresí,1739719001313284143174225265286303
vymizení20627190013150101191212255306364385
nálezu24677190013159107129181225283
urachu2977524001315890140188246303
v33035240013150
čase.3376524001314999138191208
Riziko3608524001315578121144189246
vzniku3877524001315096155177222280
malignity41805240013190139161183242300321355406
v46095240013150
ponecha‑46825240013161120178231281339387421
ném29775390013159111199
urachu3196539001315889139187244300
považují35165390013161119167216260317339361
za3896539001314595
minimální.40115390013189111168189277325347404425443
Nicméně4474539001317091139227280337390
jasně4884539001312371110167219
propracovaná2977554001316193149210242291340396444494552601
problematika3606554001316193149210233286375423456478523574
délky42085540013160113135180232
dispenzarizace4468554001316082121180234292336387418441485536584635
těchto2977569001313485134192224280
nemocných32815690013159112201259309367413460518
není38235690013159112170191
dořešena40395690013159117149201241293351400
(13,4463569001312977121138
14,46255690013154101118
15,4767569001315398114
16).49055690013154100127142
Anomálie31275840013164122181270319341363415
urachu,3565584001315990140189246303321
zejména3909584001314496118207260318366
ty4298584001313486
se4406584001314195
sklonem4523584001314186111169227280369
k49155840013147
re‑4984584001313384119
tenci2977599001313485143191213
sekretu,3212599001314194140173225258316334
mají35675990013190139161183
sklon3772599001314186110168227
k40205990013147
infekčním4089599001312380108160206253310332421
komplikacím.45325990013146103193252275297342393441463552571
Sama2977614001315098185232
antibiotická32286140013149105136157215236292323344391435484
léčba3731614001312374122179228
pak39786140013159108152
nemusí41486140013158110196252290310
k44776140013145
řešení4541614001313282120172228249
infekce4808614001312379105156200246295
stačit2977629001314176126174196229
a32396290013150
je3321629001312476
nezbytné34306290013159112157218265302361414
přistoupit3876629001316193116155189246304364386420
k43286290013147
derivaci44076290013160113145167217267316337
retence4777629001313284117168226275326
zánětlivého2977644001314494152204236258280328380437495
sekretu.3492644001314193138171222255312331
V38436440013155
úvahu39186440013158107156214270
připadá4208644001316092114173222281329
pouhá45576440013161119177234282
incize4859644001312380128150193244
s29776590013141
drenáží,3038659001316092143201250294316334
pokud33936590013160119166224283
je3697659001312376
ale3793659001315072125
ložisko3938659001312482124147186231287
hluboko4246659001315981138197256303359
a46266590013150
je4696659001312476
ohrani‑47936590013158117148198256277310
čeno,29776740013149100158216233
je3232674001312376
indikována3330674001312280139161207263312361419468
punkce38206740013160119176222269320
s41626740013141
drenáží4224674001316091143201250294316
ložiska.4562674001312482124147186231281300
V48846740013156
na‑49626740013159108141
šem2977689001314193182
souboru3179689001314098156215273305363
dva35626890013159108157
případy3739689001316192114173223282330
závažných4088689001314595142191235293339386443
infekcí4551689001312380107159204251273
dobře48436890013160118177209260
reagovaly2977704001313284132191250298348370418
na34237040013159107
antibiotickou35587040013150108140162221244301334356404450506564
léčbu4150704001312376126185243
díky4421704001316081129181
provedené4630704001316092149197249309362420473
drenáži2977719001316091143201249294316
ještě3317719001312476116151202
před3543719001316092143204
definitivní37717190013160113138165222244277299349408429
operací42247190013159119173205255303325
(7,457371900131298288
10,46857190013153101118
17,4827719001315497103
18).49557190013153100126141
Obr.6233740013779146188211
5.856374001376189
Cystogram.1000374001315997134165217273303354440459
Po14793740013152105
zacévkování1603374001314497142185231275328374426482503
močového21263740013187141187239284329384438
měchýře258437400131871336233890013146102145176221
a8713890013156
aplikaci9543890013156111134156200254300322
kontrastní1303389001314599156187217269306337394415
látky1745389001312378109154202
se1974389001313884
zobrazuje2085389001314497153184236280336357404
kanál25163890013146100156211233
(šipky)62340400131296686140185231257
perzistujícího8964040013155101132175197231262317337359403424481535
urachu1447404001315686137181236290
spojující1754404001313790145166220241262307328
močový20984040013187141187239283331
měchýř24454040013187133177232274304
s6234190013138
pupkem6814190013155110165209254340
Fig.623434001375784147174
5.814434001376086
Cystogram.953434001315894130160210264293343426445
After1413434001315883116159188
catheterization1616434001314596125179223253296325345386437466487539593
of2224434001315480
the2320434001313185129
urinary2464434001315484104157210239285
bladder623449001315576130184237282312
and9514490013155110163
administering11314490013154108193214269289323354397427448502556
contrast1703449001314596151180210261296326
material,20454490013187140170213243264317338356
the2417449001313286131
channel256444900131461001536234640013157113160181
(indicated831464001313051106161183228282313357412
by1270464001315699
arrows)1396464001315687118171247284309
of1732464001315583
the1841464001313389135
persistent20024640013156103134172192227259303359390
urachus2418464001315687139184240295330
connecting623479001314698154209255300333354409463
the1106479001313287133
bladder1259479001315577131186240286317
to1595479001313385
the1700479001313287133
umbilicus18534790013155141196218239260305359394
is2267479001312257
visualized2344479001314668103156210231253295339393
Obr.29763740013781149193217
6.3224374001376292
Fistulogram.3374374001314971107139195217273330362414503523
Při3924374001315484106
plnění4057374001315780137184241263
perzistujícího43473740013157105136182204240272328350373419441500555
sinu4930374001313960116172
urachu2976389001315788140186242298
kontrastní33013890013146100157188219271308340396418
látkou3746389001312378110154209265
přes4039389001315687132170
píštěl4236389001315679119150194216
v44803890013147
pupeční45543890013156112168216261317339
jizvě492038900131224587137182
a29764040013155
současně3048404001313891147191244279333379
provedeným3444404001315586138184228283328384426513
cystogramem3973404001314692129160213268298349436482568
neprokázána45584040013156102157188241285338381434490544
komunikace2976419001314598185239295316360413458501
mezi34974190013188134178199
měchýřem37164190013187133178233275305349436
a41714190013156
pupkem42474190013155110165209254340
(šipka)460741900131296687141186239265
Fig.2976434001375887152182
6.3188434001376191
Fistulogram.3335434001314869105136191213268324354406493513
During38744340013170126157178234289
filling41894340013126517395116172227
of4443434001315582
the4552434001313388135
persistent47134340013156103134172192227259303359389
urachal2976449001315584133177230282303
sinus3294449001313756109162196
with3505449001317494124177
contrast3697449001314595149178207256291321
material40334490013185138167209238259311331
through4379449001313285114165219272325
the4719449001313285129
fistula486344900131255083113166186239
in2976464001312377
the3070464001313186131
umbilical32184640013155140194215236257302354375
scar,3609464001313882134164178
no38034640013156110
communication3929464001314697183268322377398442494525545599654
between46004640013155101132209253299354
the4970464001313287132
bladder2976479001315577132186240286317
and33134790013155111165
the3498479001313287133
umbilicus36514790013155142196218239260305359394
is4065479001312357
demonstrated41424790013156101188242298333364395446477520575
(arrow)4737479001312980111141194269294