A case of urachal remnant presenting as acute abdominal pain

Schlaishunt, Scott; Rubin, Jonathan M.

doi:10.1016/s0736-4679(98)00161-9

Cited by 9 publications

(13 citation statements)

References 17 publications

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“…2,5 However, a large number of other presentations have been reported. 1,2,4,7 The expanded differential diagnosis of an infected urachal cyst includes acute pelvic inflammatory disease, cystitis, inflammatory bowel disease, perforated viscus, strangulated umbilical hernia, intraabdominal or pelvic abscess, and Meckel diverticulum. 5 They may induce acute abdominal pain due to intracyst hemorrhage, intra-abdominal rupture leading to peritonitis with or without secondary infection, intestinal obstruction, obstructive uropathy with or without superimposed urinary tract infection, or fascitis and/ or myonecrosis of the abdominal wall secondary to extraabdominal rupture.…”

Section: Discussionmentioning

confidence: 99%

“…Urachal cysts may present after calcification of the cyst wall or calculus formation within the cyst. 1,2 The broad differential diagnosis for urachal cysts is due, at least in part, to the many complications associated with this disorder. 2,5,6 In addition, fistulization may occur between an infected urachal cyst and a loop of bowel, the bladder, or the skin in the periumbilical or inguinal regions.…”

Section: Discussionmentioning

confidence: 99%

“…5 They may induce acute abdominal pain due to intracyst hemorrhage, intra-abdominal rupture leading to peritonitis with or without secondary infection, intestinal obstruction, obstructive uropathy with or without superimposed urinary tract infection, or fascitis and/ or myonecrosis of the abdominal wall secondary to extraabdominal rupture. 1,5,7 Malignant degeneration into adenocarcinoma, sarcoma, or transitional cell carcinoma has been described in urachal remnants. These fistulas lead to presentations consistent with intestinal obstruction, urinary tract infections, or skin abscess, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…2,5,6 In addition, fistulization may occur between an infected urachal cyst and a loop of bowel, the bladder, or the skin in the periumbilical or inguinal regions. 1 In addition, infection with a multitude of organisms has been reported. The myriad of possible presentations produces the high rate of incorrect preoperative diagnosis for urachal cysts, which has been reported to be as high as 35%.…”

Section: Discussionmentioning

confidence: 99%

“…1 In most missed cases, as in the patient presented below, an incorrect diagnosis is not critical as the patient usually presents multiple times for evaluation. 1 In most missed cases, as in the patient presented below, an incorrect diagnosis is not critical as the patient usually presents multiple times for evaluation.…”

mentioning

confidence: 99%

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Acute Presentation of Infected Urachal Cysts

Allen¹,

Song²,

Velcek³

2004

Pediatric Emergency Care

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Urachal remnants, although relatively rare, masquerade as a large number of diverse disorders leading to a high rate of misdiagnosis. A typical case is reported in which a 10-year-old boy presented to the Emergency Department twice before being incorrectly diagnosed with a pelvic or lower abdominal periappendiceal abscess. Definitive diagnosis and treatment of an infected urachal cyst were made intraoperatively. A review and discussion of urachal remnants is presented, and a diagnostic algorithm and treatment plan is offered for this entity.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Acute Presentation of Infected Urachal Cysts

Allen¹,

Song²,

Velcek³

2004

Pediatric Emergency Care

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Inflamed urachal cyst containing calculi in an adult

Milotič

Fučkar

Gazdik

et al. 2002

J of Clinical Ultrasound

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The urachus is an embryonic structure that persists after birth in some individuals and can cause various problems. We report a case of an inflamed urachal cyst filled with a thick yellow fluid and several calculi in a woman with a 1-month history of dysuria. Physical examination revealed a fist-sized tumor located infraumbically in the midline. The patient's erythrocyte sedimentation rate was elevated; the results of all other routine laboratory studies were normal. Sonography showed a regularly shaped, ovoid, hypoechoic cystic area in the abdominal wall measuring 8 x 4 x 3 cm and containing several hyperechoic masses associated with acoustic shadowing. The wall of the cyst was inhomogeneous, and a thin hypoechoic linear tract linked the superior aspect of the mass to the umbilicus. The results of excretory urography, voiding cystography, and cystoscopy excluded an abnormality of the urinary system. A urachal cyst was diagnosed, and the mass was surgically removed. The surgical specimen was sent for histopathologic analysis, which confirmed the diagnosis.

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Red Umbilicus as a Clinical Manifestation in a 19‐Month‐Old Girl with Typhoid Colonic Perforation

Chang

Lin

2007

The Kaohsiung J of Med Scie

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Redness of the umbilicus is usually considered to be a reliable sign of underlying gangrenous bowel or peritonitis in tiny infants but seldom among non-neonatal patients. We report a 19-month-old girl with final diagnosis of typhoid colonic perforation who initially presented with abdominal distention and umbilical erythema on arrival at our emergency department. The redness of umbilicus diminished gradually after laparotomy. Thin abdominal wall, severe intra-abdominal soiling, and polymicrobial infection accounted for the inflammatory process spreading to the skin of the umbilicus. Because of its rarity beyond the neonatal period, prompt diagnosis depends on maintaining a high index of suspicion when the abdomen is distended and suddenly tender to palpation.

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A case of urachal remnant presenting as acute abdominal pain

Cited by 9 publications

References 17 publications

Acute Presentation of Infected Urachal Cysts

Acute Presentation of Infected Urachal Cysts

Inflamed urachal cyst containing calculi in an adult

Red Umbilicus as a Clinical Manifestation in a 19‐Month‐Old Girl with Typhoid Colonic Perforation

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